A weak stream, straining and a feeling of incomplete emptying are common complaints in men over the age of 50, but describing them is subjective. Uroflowmetry turns the feeling into a measurable value: it records how fast and in what volume the urine flows out and shows Dr Penev whether passing urine really is difficult, and to what degree.
The test is painless, takes minutes and needs no instruments, catheter or radiation, which is why it is one of the first steps in a consultation for urinary problems.
When it is recommended
Dr Penev most often arranges uroflowmetry for:
- a weak, thin or interrupted stream and straining in difficulty passing urine;
- symptoms of an enlarged prostate (BPH) – before treatment and to check how well it is working;
- suspected urethral stricture – a narrowing of the urinary channel;
- follow-up after prostate or urethral surgery;
- frequent and night-time urination, to judge whether the cause lies in the outflow or in the bladder itself;
- children and young people with voiding problems.
If you cannot pass urine at all and your bladder is full and painful, this is acute urinary retention – an emergency. Do not wait for a booked appointment; go to an emergency department or call 112 (the European emergency number).
What happens
The test is done in a calm setting with no one else present, because nervousness distorts the result. You pass urine in the usual way into a special funnel connected to a measuring device, which records the amount of urine every second and displays it as a curve.
From the curve Dr Penev reads the maximum and average flow rate, the volume passed and the time taken. A normal curve is bell-shaped. A low, flat and prolonged curve suggests an obstruction in the path of the urine, for example an enlarged prostate or a stricture, while a jagged, interrupted curve suggests straining or a weak bladder muscle. In men, a maximum flow rate of roughly more than 15 ml/s is considered good, and values of roughly less than 10 ml/s indicate significant difficulty; the interpretation depends on age, sex and the volume passed.
The whole test takes about ten minutes. Straight afterwards an ultrasound of the bladder with measurement of residual urine is usually done: the stream shows how the bladder empties, and the residual urine shows whether it empties completely.
Preparation
- Come with a moderately full bladder and a natural urge to go – drink about half a litre of water around an hour before your appointment.
- Do not hold on until it hurts; an overfull bladder gives just as inaccurate a result as an almost empty one.
- For a reliable reading, the volume passed should be at least about 150 ml; if it is less, the test is repeated.
- Bring a list of the medicines you take.
- You do not need to fast.
After the test – what it shows
The result is ready straight away, and Dr Penev discusses it with you during the consultation, together with the ultrasound and your symptoms. Uroflowmetry shows whether the stream is weak and by how much, but not always why – an obstruction in the urethra and a weak bladder muscle can produce a similar curve; in that case further tests are discussed, for example cystoscopy or a urodynamic study. When the measurement is repeated after a few months of treatment, it is clear whether the stream has improved.
Where it is done
Uroflowmetry is done by appointment at Dr Penev’s urology practice in Plovdiv, 5 Anri Barbyus St, depending on the equipment available; if necessary, the test is arranged through Kaspela University Hospital (UMBAL Kaspela), Plovdiv. Patients from Karlovo can ask when booking whether the test is possible at Vita Med Medical Centre, Karlovo.
Price
An initial consultation with Dr Penev is €50 and a follow-up consultation €30. The price of uroflowmetry is confirmed when you book.
If your stream has become weaker or you get up several times a night, do not put off finding the cause. Book an appointment with Dr Penev and come with a moderately full bladder – the test takes minutes, and its answers determine the next steps in treatment.
Frequently asked questions
Can I have uroflowmetry if I am taking medicines?
Yes, but it is important that Dr Penev knows which medicines you take. Prostate medicines, some cold remedies, antidepressants and diuretics change the strength of the stream, and this is taken into account when the result is interpreted.
Why is uroflowmetry sometimes repeated?
The stream is different every time you pass urine and depends on how much is in the bladder and on nervousness. If the amount passed is small or the curve is unusual, the test is repeated so that the result is reliable.
Is uroflowmetry enough to find the cause of a weak stream?
It shows whether the stream is weak and by how much, but not always why. That is why it is interpreted together with the ultrasound, the residual urine and the examination, and in some cases a full urodynamic study is arranged.
Is uroflowmetry suitable for children and women?
Yes. The test is non-invasive and is used in children with voiding problems and in women with a weak stream or a feeling of incomplete emptying. Normal values are interpreted according to age and sex.
The information on this website is for general education and does not replace an examination and consultation with a doctor. If you have urgent symptoms, seek medical help immediately or call 112.