# A Repeatability Study of Measurement of Micturition With Voiding Sonography and Uroflowmetry of Asymptomatic Women

## TL;DR

This study evaluated the consistency of measuring micturition in women using ultrasound and uroflowmetry, finding that the method is repeatable and mostly unaffected by transducer placement.

## Contribution

The study demonstrates the feasibility and repeatability of voiding sonography combined with uroflowmetry in asymptomatic women.

## Key findings

- Most sonographic measures showed good to excellent intra- and inter-tester repeatability.
- Bladder neck and urethral diameter measurements were more repeatable when timed with maximum flow from uroflowmetry.
- Perineal transducer placement affected voiding in 20% of participants.

## Abstract

This study aimed to assess the intra‐ and inter‐tester repeatability of voiding sonography measures in asymptomatic women and to examine the effect of perineal transducer placement on uroflowmetry.

A prospective observational study of 32 asymptomatic women was conducted using ultrasound with simultaneous uroflowmetry. Participants completed four voids (two per day). The ultrasound transducer placed on the perineum assessed bladder neck and urethral displacement during micturition. On Day 1, a void with ultrasound and uroflow recorded by a sonographer was compared to a void recorded with uroflowmetry only to determine whether the transducer placement affected voiding. On Day 2, two sonographers evaluated the voids with ultrasound and uroflowmetry. Each sonographer measured their own images. One sonographer also made measures on the images recorded by the second sonographer. Uroflowmetry measures and void patterns were evaluated. The repeatability of ultrasound measures was analyzed using intraclass correlation coefficient (ICC 2,1) and Bland–Altman analysis, and t tests examined the transducer's impact on uroflowmetry.

Some changes in flow rate and flow pattern (20% of participants) were observed with placement of the transducer. Most sonographic measures showed good to excellent inter‐ and intra‐tester repeatability, and between measures made by the different testers on the same image. During void, bladder neck and urethral diameter were more repeatable if measures were made at the time of maximum flow estimated from the simultaneous uroflowmetry.

Voiding sonography is both feasible and repeatable. Perineal transducer placement affected micturition for some individuals. Voiding sonography combined with uroflowmetry shows promise for a noninvasive urogynecology functional assessment.