Endoscopic Dynamic Hydrodistension Classification for the Ureteral Orifice in Vesicoureteral Reflux: Is There Good Concordance Between Observers?

Daniel Ortiz-Seller*, Jorge Panach-Navarrete, Lorena Valls-González and José María Martínez- Jabaloyas

Department of Urology, University Clinic Hospital of Valencia, INCLIVA, Instituto de Investigation Sanitaria, Facultat de Medicine I Odontology, Universitas de València, Valencia, Spain

^*Correspondance to: Ortiz-Seller D 

 PDF  Full Text Research Article | Open Access

Abstract:

Introduction: The Dynamic Endoscopic Hydrodistension Grade is a categorical scale useful for defining the degree of ureteral opening during endoscopic treatment of Vesical Ureteral Reflux (VUR). Objectives: To verify the interobserver concordance of the Dynamic Endoscopic Hydrodistension Grade classification. Material and Methods: Prospective observational study, collecting consecutive cases of endoscopic treatment for VUR in our centre for two years. Baseline characteristics of the sample were collected. In addition, two experienced paediatric urologists, along with a less experienced resident, blindly recorded (without sharing with the rest) the grade they thought corresponded to the meatus that had just been injected. The grades on the scale cover 4 categories, from H0 (closed meatus with hydrodistension) to H3 (total opening of the meatus, including ureteroscopy with the cystoscope). A descriptive analysis of the sample was carried out, and the kappa coefficient was studied to check the interobserver agreement between the expert urologists among themselves, and between each of them and the novice urologist. Results: Data were collected from a total of 54 ureteral units, 23 (42.6%) corresponding to males and 31 (57.4%) to females. The mean age at the time of injection was 32 +/- 14 months. A satisfactory, almost perfect correlation was found between expert urologists (kappa=0.766, p<0.001). On the other hand, a satisfactory correlation was found between each expert urologist and the novice urologist (kappa=0.614 with p=<0.001, and kappa=0.678 with p<0.001). Conclusions: The dynamic hydrodistension classification presents a good concordance between observers, this concordance being greater among urologists experienced with the endoscopic treatment of VUR.

Keywords:

Vesicoureteral reflux; Dynamic hydrodistension; Interobserver concordance

Cite the Article:

Ortiz-Seller D, Panach-Navarrete J, Valls-González L, Martínez- Jabaloyas JM. Endoscopic Dynamic Hydrodistension Classification for the Ureteral Orifice in Vesicoureteral Reflux: Is There Good Concordance Between Observers?. World J Surg Surgical Res. 2024; 7: 1576..