Development and validation of a bladder trabeculation grading system in pediatric neurogenic bladder

Area of Science:

• Urology
• Radiology
• Medical Imaging

Background:

• Bladder trabeculation (BT) is a common finding in neurogenic bladder (NB) patients on cystograms.
• BT often indicates a severe bladder condition requiring aggressive management.
• Standardized assessment of BT severity is lacking.

Purpose of the Study:

• To develop and validate a reliable grading system for bladder trabeculation (BT) severity.
• To enhance communication between clinicians and radiologists regarding NB.
• To establish a foundation for future research on NB.

Main Methods:

• A two-phase study involving grading system development and subsequent testing.
• Inter-rater and intra-rater reliability assessed using Cohen's Kappa, ICC, and Spearman's rho.
• Face validity confirmed by pediatric urology and radiology experts.

Main Results:

• High inter-rater reliability observed with ICC of 0.998 and Cohen's Kappa ranging from 0.795 to 1.0.
• High intra-rater reliability demonstrated with Spearman's rho correlation coefficient from 0.910 to 1.0.
• The grading system showed substantial reliability and validity.

Conclusions:

• A defined grading system for BT severity has been established.
• The system exhibits significant inter/intra-rater reliability and validity.
• This tool can improve communication on pediatric bladder wall status and support future NB studies.