Lack of consensus in atypical congenital obstructive urethral lesions in children: Snapshot of the web-based ObsCUre (obstruction to the child urethra) study
Abstract. Background. Atypical Congenital Obstructive Urethral Lesions (ACOUL) are uncommon causes of urethral obstruction in children. They include Cobb’s collar or Moorman’s ring, Type III posterior urethral valve (PUV), congenital urethral narrowing and anterior urethral valves. This study is aim...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Health
2024-03-01
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| Series: | Current Urology |
| Online Access: | http://journals.lww.com/10.1097/CU9.0000000000000092 |
| _version_ | 1797243093209055232 |
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| author | Rachel Ng Ahmed Adam Nathan Poppleton Christopher Oldmeadow Aniruddh V. Deshpande |
| author_facet | Rachel Ng Ahmed Adam Nathan Poppleton Christopher Oldmeadow Aniruddh V. Deshpande |
| author_sort | Rachel Ng |
| collection | DOAJ |
| description | Abstract. Background. Atypical Congenital Obstructive Urethral Lesions (ACOUL) are uncommon causes of urethral obstruction in children. They include Cobb’s collar or Moorman’s ring, Type III posterior urethral valve (PUV), congenital urethral narrowing and anterior urethral valves. This study is aimed to evaluate the knowledge and current practice amongst clinicians attending to ACOUL. An international online case based questionnaire was performed.
Materials and methods. A survey was administered to members of international urological societies. It included 22 clinical questions on cases with ACOUL (14 questions suitable for statistical analysis) using cases of Type I PUV as controls. Two sets of paired questions evaluated change in opinion(s) after additional information was provided.
Results. One hundred twenty-one participants responded with 71% reporting exposure of less than 5 cases per annum. In questions regarding diagnosis between 11.6% (14/121) and 21.5% (26/121) of participants identified the ACOUL as PUV. Among them, 66% of respondents agreed on ACOUL’s causative role in urethral obstruction. Gini coefficient was consistently lower for ACOUL compared to PUV: diagnosis (mean 0.33 vs. 0.44) and prognosis (0.23 vs. 0.43). High intra-rater concordance (kappa 0.420.57) was observed for paired questions–a mean of 5.79% (7.44% and 4.13% for questions 10 and 12, 16 and 17, respectively) of participants changed their answers from an alternate diagnosis to the correct diagnosis of ACOUL after viewing endoscopic images. High variation in management of ACOUL was noted (Gini 0.51).
Conclusions. This global snapshot survey identified substantial inconsistency among clinicians dealing with ACOUL. Although rarely encountered in clinical practice, better overall education of ACOUL is warranted. |
| first_indexed | 2024-04-24T18:49:38Z |
| format | Article |
| id | doaj.art-7fb1570dbf01469d9b158d6d738110e5 |
| institution | Directory Open Access Journal |
| issn | 1661-7649 |
| language | English |
| last_indexed | 2024-04-24T18:49:38Z |
| publishDate | 2024-03-01 |
| publisher | Wolters Kluwer Health |
| record_format | Article |
| series | Current Urology |
| spelling | doaj.art-7fb1570dbf01469d9b158d6d738110e52024-03-27T03:41:32ZengWolters Kluwer HealthCurrent Urology1661-76492024-03-01181121710.1097/CU9.0000000000000092202403000-00003Lack of consensus in atypical congenital obstructive urethral lesions in children: Snapshot of the web-based ObsCUre (obstruction to the child urethra) studyRachel Ng0Ahmed Adam1Nathan Poppleton2Christopher Oldmeadow3Aniruddh V. Deshpande4a Department of Paediatric Urology, John Hunter Children’s Hospital, New Lambton Heights, NSW, Australiab Division of Urology, University of the Witwatersrand, Johannesburg, South Africac Klerksdorp Hospital, Klerksdorp, South Africad CREDITSS Service, Hunter Medical Research Institute, New Lambton Heights, NSW, Australiaa Department of Paediatric Urology, John Hunter Children’s Hospital, New Lambton Heights, NSW, AustraliaAbstract. Background. Atypical Congenital Obstructive Urethral Lesions (ACOUL) are uncommon causes of urethral obstruction in children. They include Cobb’s collar or Moorman’s ring, Type III posterior urethral valve (PUV), congenital urethral narrowing and anterior urethral valves. This study is aimed to evaluate the knowledge and current practice amongst clinicians attending to ACOUL. An international online case based questionnaire was performed. Materials and methods. A survey was administered to members of international urological societies. It included 22 clinical questions on cases with ACOUL (14 questions suitable for statistical analysis) using cases of Type I PUV as controls. Two sets of paired questions evaluated change in opinion(s) after additional information was provided. Results. One hundred twenty-one participants responded with 71% reporting exposure of less than 5 cases per annum. In questions regarding diagnosis between 11.6% (14/121) and 21.5% (26/121) of participants identified the ACOUL as PUV. Among them, 66% of respondents agreed on ACOUL’s causative role in urethral obstruction. Gini coefficient was consistently lower for ACOUL compared to PUV: diagnosis (mean 0.33 vs. 0.44) and prognosis (0.23 vs. 0.43). High intra-rater concordance (kappa 0.420.57) was observed for paired questions–a mean of 5.79% (7.44% and 4.13% for questions 10 and 12, 16 and 17, respectively) of participants changed their answers from an alternate diagnosis to the correct diagnosis of ACOUL after viewing endoscopic images. High variation in management of ACOUL was noted (Gini 0.51). Conclusions. This global snapshot survey identified substantial inconsistency among clinicians dealing with ACOUL. Although rarely encountered in clinical practice, better overall education of ACOUL is warranted.http://journals.lww.com/10.1097/CU9.0000000000000092 |
| spellingShingle | Rachel Ng Ahmed Adam Nathan Poppleton Christopher Oldmeadow Aniruddh V. Deshpande Lack of consensus in atypical congenital obstructive urethral lesions in children: Snapshot of the web-based ObsCUre (obstruction to the child urethra) study Current Urology |
| title | Lack of consensus in atypical congenital obstructive urethral lesions in children: Snapshot of the web-based ObsCUre (obstruction to the child urethra) study |
| title_full | Lack of consensus in atypical congenital obstructive urethral lesions in children: Snapshot of the web-based ObsCUre (obstruction to the child urethra) study |
| title_fullStr | Lack of consensus in atypical congenital obstructive urethral lesions in children: Snapshot of the web-based ObsCUre (obstruction to the child urethra) study |
| title_full_unstemmed | Lack of consensus in atypical congenital obstructive urethral lesions in children: Snapshot of the web-based ObsCUre (obstruction to the child urethra) study |
| title_short | Lack of consensus in atypical congenital obstructive urethral lesions in children: Snapshot of the web-based ObsCUre (obstruction to the child urethra) study |
| title_sort | lack of consensus in atypical congenital obstructive urethral lesions in children snapshot of the web based obscure obstruction to the child urethra study |
| url | http://journals.lww.com/10.1097/CU9.0000000000000092 |
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