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Functional Urology · Voiding AssessmentFunctional Urology / Voiding Assessment

Uroflowmetry — Flow Shapes & What They Mean

Uroflowmetry is the simplest urodynamic test — the shape of the curve, not just the peak number, hints at what kind of voiding problem you're dealing with.

Orientation

The big picture

Uroflowmetry is the simplest urodynamic test — the patient voids into a funnel and a machine plots flow against time. Its value is that the shape of the curve, not just the peak number, hints at what kind of voiding problem you're dealing with. It can't, by itself, prove obstruction (that needs a pressure-flow study), but it's the cheap, non-invasive screen that points you in the right direction.

Golden rule

The framework: the key metrics (Qmax, voided volume, PVR), the characteristic curve shapes and what each suggests, and the crucial limitation.

Pathophysiology

Mechanism pathway

Tap any step to see why it happens.

Illustration

Curve shapes — illustrated

Normal — bell-shaped

Rapid rise, high Qmax, smooth symmetric fall.

flow time

BPH / obstruction — low plateau

Slow rise to a low Qmax, prolonged and flat.

flow time

Urethral stricture — box-like

Flat, very constant — fixed narrow calibre caps flow.

flow time

Underactive / staccato — interrupted

Fluctuating, intermittent — straining, sphincter activity.

flow time
All four plot flow rate (y) against time (x); the peak height is Qmax, but the shape is the diagnostic clue. A plateau says outflow is limited — but uroflow alone can't separate mechanical obstruction (BPH, stricture) from a weak detrusor. The shape narrows it; a pressure-flow study confirms (high pressure + low flow = obstruction; low pressure + low flow = underactive detrusor).
Work-up

Diagnostic algorithm

Each step answers one question. Tap to expand.

Exam

Board traps

Valid study needs voided volume ≥150 mL.

Qmax is the key number but can't separate obstruction from a weak detrusor — that needs pressure-flow.

Bell-shaped = normal; low flat plateau = obstruction (BPH); box-like flat = stricture; interrupted/straining = underactive detrusor or dysfunctional voiding.

Average flow is less useful than Qmax for detecting outlet obstruction.

A stricture curve is typically flatter and more uniform than a BPH curve.

Test yourself

Quiz

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