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A grading system for evaluation of bladder trabeculation

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Abstract

Purpose

To establish a parameter-based grading system for evaluating bladder trabeculation (BT).

Materials and methods

A retrospective analysis was conducted on children diagnosed with posterior urethral valve (PUV) or neurogenic bladder (NB) who underwent voiding cystourethrogram (VCUG), urodynamic testing, and urological ultrasonography between January 2016 and October 2022. Cases involving urologic surgery, secondary bladder pathology, and an interval of more than 12 months between examinations were excluded. A parameter named Bladder Dispersion (BD) was calculated through fluoroscopic images, and the grading system was developed as follows: BD < 40 (Grade 0), 40 ≤ BD < 60 (Grade 1), 60 ≤ BD < 90 (Grade 2), BD ≥ 90 (Grade 3). Grades 0–1 were classified as low-risk group, while grades 2–3 were classified as high-risk group. Analysis of variance, Kruskal–Wallis test, and Chi-square test were performed to compare urodynamic results and complications across different grades and groups.

Results

A total of 74 patients were eligible to participate, which included 46 boys (62.2%) and 28 girls (37.8%), the mean age was 75.18 ± 48.39 months. Among them, 11 (14.9%) were PUV, 50 (67.6%) were NB, and 13 (17.5%) were PUV and NB. Significant differences were observed in maximum detrusor pressure, post-void residual urine ratio, and compliance among grades 0–3. Severe hydronephrosis and histories of urinary tract infection were more prevalent in the high-risk group.

Conclusion

A reliable grading system with objective standards was proposed which could aid in the assessment of BT severity.

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Data availability

On demand.

Abbreviations

BT:

Bladder trabeculation

VCUG:

Voiding cystourethrogram

PUV:

Posterior urethral valve

NB:

Neurogenic bladder

LUTS:

Lower urinary tract symptoms

UTI:

Urinary tract infection

VUR:

Vesicoureteral reflux

BD:

Bladder dispersion

MDP:

Maximum detrusor pressure

C:

Compliance

BC:

Bladder capacity

PVR:

Post-void residual urine

PVR-R:

Post-void residual urine ratio

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Acknowledgements

The authors would like to thank Department of Urology Children’s Hospital of Chongqing Medical University for providing data for this work. This research was partially supported by the Program for Youth Innovation in Future Medicine, Chongqing Medical University, Yuzhong, Chongqing, People’s Republic of China.

Funding

This work was supported by the Program for Youth Innovation in Future Medicine, Chongqing Medical University, Yuzhong, Chongqing, People’s Republic of China.

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Authors and Affiliations

  1. Department of Urology Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, People’s Republic of China

    Xiao Wang, Hong-song Chen, Chong Wang, Xing-guo Luo, Yan-xi Wang, Zi-han Ye, Xing Liu & Guang-hui Wei

  2. China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, People’s Republic of China

    Xiao Wang, Hong-song Chen, Chong Wang, Xing-guo Luo, Yan-xi Wang, Zi-han Ye, Xing Liu & Guang-hui Wei

  3. Children’s Hospital of Chongqing Medical University, Chongqing, People’s Republic of China

    Xiao Wang, Hong-song Chen, Chong Wang, Xing-guo Luo, Yan-xi Wang, Zi-han Ye, Xing Liu & Guang-hui Wei

  4. Chongqing Key Laboratory of Pediatrics, Chongqing, People’s Republic of China

    Xiao Wang, Hong-song Chen, Chong Wang, Xing-guo Luo, Yan-xi Wang, Zi-han Ye, Xing Liu & Guang-hui Wei

  5. Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, People’s Republic of China

    Xiao Wang, Hong-song Chen, Chong Wang, Xing-guo Luo, Yan-xi Wang, Zi-han Ye, Xing Liu & Guang-hui Wei

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  1. Xiao Wang
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  2. Hong-song Chen
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  8. Guang-hui Wei
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Contributions

XW: designed the study, analyzed the images, and drafted the manuscript. XL: designed the study and manuscript editing. HC, CW, XL, YW, ZY: participated in the imaging analysis and manuscript writing. GW: revised the manuscript and helped analyze images. All authors reviewed and approved the final version of the manuscript.

Corresponding author

Correspondence to Xing Liu.

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Conflict of interest

No conflict of interest.

Ethical approval

The study was approved by the Ethics Committee of Children’s Hospital of Chongqing Medical University (Approval number 2023267).

Informed consent

Consent was taken from all participants.

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Wang, X., Chen, Hs., Wang, C. et al. A grading system for evaluation of bladder trabeculation. World J Urol 41, 2443–2449 (2023). https://doi.org/10.1007/s00345-023-04527-4

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