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Evaluation of Urinary Tract Dilation Classification System for Grading Postnatal Hydronephrosis.

Amr Hodhod1, John-Paul Capolicchio2, Roman Jednak2

  • 1Departments of Surgery and Pediatric Surgery, Montreal Children's Hospital, McGill University, Montreal, Quebec, Canada; Department of Urology, Faculty of Medicine, Menoufia University, Al Minufya, Egypt.

The Journal of Urology
|November 4, 2015
PubMed
Summary

The Urinary Tract Dilation classification system reliably grades postnatal hydronephrosis. It is also valid in predicting the need for surgical intervention in pediatric patients.

Keywords:
diagnosishydronephrosismultivariate analysispatient outcome assessment

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Area of Science:

  • Pediatric Urology
  • Medical Imaging
  • Diagnostic Accuracy

Background:

  • Postnatal hydronephrosis requires accurate grading for appropriate management.
  • Existing grading systems, like the Society for Fetal Urology system, have limitations.
  • A novel grading system, the Urinary Tract Dilation (UTD) classification system, has been proposed.

Purpose of the Study:

  • To assess the reliability and validity of the Urinary Tract Dilation (UTD) classification system.
  • To compare the UTD system against the Society for Fetal Urology (SFU) system for grading postnatal hydronephrosis.
  • To determine the UTD system's ability to predict hydronephrosis resolution and surgical intervention.

Main Methods:

  • Retrospective review of 490 patients with hydronephrosis (2008-2013).
  • Exclusion of cases with urinary tract infection, neurogenic bladder, chromosomal anomalies, or extraurinary malformations.
  • Comparison of UTD classification with SFU grading for reliability and predictive validity using univariate and multivariate analyses.

Main Results:

  • The UTD classification system demonstrated high reliability (parallel forms 0.92).
  • Of 730 renal units, 49% resolved, and 12% required surgical intervention.
  • Multivariate analysis showed UTD risk group independently predicted surgical intervention, while SFU grades predicted resolution.

Conclusions:

  • The Urinary Tract Dilation (UTD) classification system is a reliable tool for evaluating postnatal hydronephrosis.
  • The UTD system is valid in predicting the likelihood of surgical intervention in pediatric patients.
  • The UTD system offers a valuable alternative for grading and managing hydronephrosis.