A new grading system for evaluation of uroflowmetry-EMG results (Gülhane Grading System)

Abstract

Aim: It is recommended that dysfunctional voiding diagnosis should made by the repeated uroflowmetry simultaneously pelvic floor electromyography (UF-EMG) + post void residual measurements. However, there is no evaluation system for UF-EMG parameters regarding the clinical diagnosis, follow up and treatment of these patients. In our study, we aimed to create a new grading system for the diagnosis of dysfunctional voiding by using UF-EMG parameters.
 Materia and Method: We have retrospectively obtained UF-EMG and lower urinary tract symptom score results that performed to the children whom applied to our clinic with the symptoms of dysfunctional voiding between 2010 and 2015. A total of 856 reports were included into this retrospective cohort analysis. The proper 610 UF-EMG tests were graded according to our grading system. The UF-EMG grading system is divided into 4 grades: Grade 0: No EMG activity and normal uroflowmetry, Gradenon-EMG: Disturbed flow pattern with no EMG activity, Grade 1: EMG activity with no disturbed flow pattern, Grade 2: EMG activity with minimally disturbed flow pattern, Grade 3: EMG activity with moderately disturbed flow pattern, Grade 4: EMG activity with extremely disturbed flow pattern. 
 Results: There was no statistically significant difference between the demographic data of patient and control groups (p>0.05). According to grading system, day and nighttime incontinence were statistically significant increases as the grades increases (respectively, p