Understanding uroflow Qmax during pubertal development

This is the authors' abstract. We don't add key points for this paper.

Objectives: Although we regularly perform uroflow tests on our patients, little is known about the change in flow rates during pubertal development. Materials and Methods: A total of 48 boys (aged 11–18) were recruited in two secondary schools. Based on colored illustrations and a description of each stage, a Tanner self-assessment tool for pubertal development was created. After each boy assessed his Tanner stage, an objective evaluation was undertaken by a blinded medical assessor. Next, the boys returned to their classroom and were instructed to drink 300 mL of water. When they felt an urge to empty their bladder, a uroflow test was performed, and their urge was assessed based on the International Continence Society criteria. Boys with voiding issues, non-bell-shaped curves, a history of urethral surgery, or urge 0/4 were excluded. Results: Subjective and objective Tanner agreement was 16.7% for stage 1, 81.8% for stage 2, 25.0% for stage 3, 80.0% for stage 4, and 100% for stage 5. For uroflow statistics, six boys were excluded. There was no statistical difference in Qmax based on their age ( P = 0.152); however, a significant difference was noted based on the Tanner genital (G) stage ( P < 0.001) with mean values ranging from 18.5 (±3.0) mL/s in Tanner 2 to 31.2 (±5.6) mL/s in Tanner 4. A significant difference was found between Tanner 1 and Tanner 3 ( P = 0.020) and Tanner 4 ( P < 0.001) and between Tanner 2 and Tanner 3 ( P = 0.002), Tanner 4 ( P < 0.001), and Tanner 5 ( P = 0.021). There was no significant difference in Qmax between Tanner 1 and Tanner 2 ( P = 0.973) or between Tanner 3 and Tanner 4 ( P = 0.596). Conclusion: During pubertal development, it is better to evaluate Qmax in relation to the Tanner stage instead of age. Tanner stage self-assessment is generally unreliable, especially in early puberty. While accuracy may improve in stages 4 and 5, physical examination remains necessary for precise staging.