International Neurourology Journal最新文献

{"title":"Bladder Digital Twins for Neuromodulation: Current Platforms and a Roadmap to Closed-Loop Therapy.","authors":"Thar Htet Nyan, Suhyeok Kim, Eunkyoung Park","doi":"10.5213/inj.2652040.020","DOIUrl":"10.5213/inj.2652040.020","url":null,"abstract":"<p><p>Bladder disorders such as overactive bladder and neurogenic bladder impose a major symptom burden, yet neuromodulation therapies are largely delivered with fixed open-loop settings and limited adaptation to time-varying bladder states. Bladder digital twins are patient-anchored computational models linked to sensing streams and updated via state estimation and/or data assimilation. They offer a pathway to closed-loop personalized therapy, but bladder implementations remain fragmented across modeling, sensing, and stimulation. This review synthesizes digital-twin technologies relevant to bladder physiology, sensing, and neuromodulation and translates lessons from mature organ digital twins to bladder requirements for closed-loop control. We conducted targeted searches of PubMed, Web of Science, IEEE Xplore, and Google Scholar (2013-2025). We reviewed digital-twin paradigms for the heart, brain, lungs, liver, and kidney and summarized bladder approaches including finite-element bladder-wall mechanics, conductivity-based torso models for wearable bioimpedance optimization, strain-to-geometry reconstruction using stretchable sensors, and sensor-informed closed-loop control. Clinically deployable twins pair mechanistic structure with limited reliable data streams and use hybrid estimation for indirect, noisy measurements. In bladder applications, feasibility has been demonstrated for state estimation and model-guided design; key barriers include ambulatory motion artifacts and impedance drift, sparse clinical anchors for personalization, limited longitudinal human validation, and incomplete safety engineering for stimulation control. A roadmap toward closed-loop bladder digital twins should prioritize ambulatory-grade sensing with artifact handling and recalibration, uncertainty-aware real-time state estimation, modelinformed stimulation optimization, and fail-safe control with standardized reporting of accuracy, latency, uptime, and drift.</p>","PeriodicalId":14466,"journal":{"name":"International Neurourology Journal","volume":" ","pages":"178-191"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Electrical Spinal Cord Stimulation on Lower Urinary Tract Dysfunction in Mice With Spinal Cord Injury.","authors":"Kang Jun Cho, Sergei Karnup, Mamoru Hashimoto, Kanako Matsuoka, Stephanie L Daugherty, Tadanobu Kamijo, Joon Chul Kim, Naoki Yoshimura","doi":"10.5213/inj.2652026.013","DOIUrl":"10.5213/inj.2652026.013","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to assess the effects of electrical stimulation of the L3-4 spinal cord containing the lumbar spinal coordinating center (LSCC) for neurogenic lower urinary tract dysfunction (NLUTD) in mice with spinal cord injury (SCI).</p><p><strong>Methods: </strong>Male mice were divided into spinal cord intact (SI) and SCI groups. Two electrodes were placed over the epidural surface of the L3-4 spinal cord for electrical spinal cord stimulation (SCS). SCS was initiated when the intravesical pressure of voiding bladder contractions began rising. Cystometrograms (CMG) and external urethral sphincter (EUS)-electromyography (EMG) were recorded before, during and after SCS to examine the effects of SCS on CMG and EUS-EMG parameters in each group.</p><p><strong>Results: </strong>In SI mice, significant differences in CMG parameters were not found after SCS compared to pre-SCS values. However, in SCI mice, the ratio of the voided volume to bladder filling volume was significantly higher after SCS compared to pre- SCS values (P<0.001). Additionally, SCI mice after SCS showed a significantly lower nonvoiding contraction number (P=0.017) and a shorter intercontraction interval (P=0.007) compared to those without SCS. EUS-EMG parameters in SI mice without and with SCS showed no significant differences in the ratio of active phases (AP) to silent phases (SP). In contrast, SCI mice with SCS had a significantly lower AP to SP ratio compared to those without SCS (P<0.001).</p><p><strong>Conclusion: </strong>SCS applied to the L3-4 spinal cord can improve detrusor sphincter dyssynergia by increasing EUS relaxation to mitigate inefficient voiding as well as detrusor overactivity in SCI. Restoration of the LSCC function by SCS could be a therapeutic modality to improve NLUTD after SCI.</p>","PeriodicalId":14466,"journal":{"name":"International Neurourology Journal","volume":"30 3","pages":"233-242"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Virtual Reality Glasses Application During Urodynamics on Procedural Pain, Anxiety, and Hemodynamic Parameters: A Randomized Controlled Trial.","authors":"Elife Kettaş Dölek, Gamze Bozkul, Gülay Altun Uğraş, Murat Bozlu","doi":"10.5213/inj.2550260.130","DOIUrl":"10.5213/inj.2550260.130","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the effectiveness of virtual reality glasses (VRG) intervention during urodynamic testing (UT) on procedural pain (PP), anxiety levels, and hemodynamic parameters.</p><p><strong>Methods: </strong>This prospective, randomized controlled trial enrolled 84 patients undergoing UT, randomized 1:1 to VRG (n=42) or control group (n=42). The VRG group viewed immersive 3-dimensional nature videos via VRG throughout the procedure, while controls received routine care. Primary outcomes included PP (visual analogue scale) and anxiety levels (State Anxiety Inventory) assessed at baseline (pre-UT1), immediately postprocedure (post-UT2), and 15 minutes postprocedure (post-UT3). Secondary outcomes comprised hemodynamic parameters (systolic blood pressure [SBP], diastolic blood pressure [DBP], heart rate [HR], respiratory rate [RR], oxygen saturation [SpO₂]) measured at identical timepoints.</p><p><strong>Results: </strong>Groups demonstrated comparable baseline characteristics and PP scores (VRG: 2.52±2.76 vs. control: 3.07±2.99, P=0.386). While baseline anxiety levels were similar between groups, the VRG group exhibited significantly lower postprocedural anxiety scores (post-UT2: 34.64±4.98 vs. 39.21±8.11, P=0.003; post-UT3: 34.45±4.68 vs. 39.45±8.27, P=0.001). Hemodynamically, the VRG group demonstrated significantly reduced DBP at post-UT3 (73.4±9.7 mmHg vs. 78.7±12.0 mmHg, P=0.028) and lower RRs at both postprocedural timepoints (P<0.001 and P=0.015, respectively). No significant between-group differences were observed for SBP, HR, or SpO₂.</p><p><strong>Conclusion: </strong>VRG intervention during UT effectively reduced postprocedural anxiety and demonstrated beneficial effects on RR and DBP, without significantly impacting PP. These findings support the use of VRG by nurses as a safe, nonpharmacological adjunct for enhancing patient comfort during invasive urological procedures.</p>","PeriodicalId":14466,"journal":{"name":"International Neurourology Journal","volume":"30 2","pages":"105-117"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13342842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time-Series Analysis of Detrusor Pressure as an Adjunctive Parameter for Diagnosing Bladder Outlet Obstruction in Men.","authors":"Ana Vidal-Brandt, Karina Villaseñor-Álvarez, Sofia Terán-Amaya, Immer Noyola-Ávila, Eduardo Cárdenas-Cárdenas, Rubén Fossion, Jorge Moreno-Palacios","doi":"10.5213/inj.2652050.025","DOIUrl":"10.5213/inj.2652050.025","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate whether time-series analysis of detrusor pressure during the pressure-flow phase provides diagnostic information that complements conventional urodynamic parameters in the assessment of bladder outlet obstruction (BOO) in men with lower urinary tract dysfunction.</p><p><strong>Methods: </strong>An observational, analytical, cross-sectional study was conducted including men ≥18 years undergoing urodynamic evaluation for voiding dysfunction. Pressure-flow studies were performed according to International Continence Society standards. Detrusor pressure data recorded during voiding were exported at one-second resolution and analyzed as timeseries restricted to the active flow phase. From these segments, descriptive statistical metrics were derived, including mean detrusor pressure during voiding (mPeDet). BOO was classified using conventional indices and final clinical judgment by an experienced urologist, which served as the reference standard. Diagnostic performance was assessed using receiver operating characteristic (ROC) analysis and Cohen kappa.</p><p><strong>Results: </strong>Forty-one patients were included (median age, 59 years). mPeDet showed a strong correlation with the bladder outlet obstruction index (r=0.89, P<0.001). ROC analysis demonstrated excellent diagnostic performance for mPeDet in identifying BOO, with an area under the curve of 0.95. A cutoff value of 37 cm H₂O yielded a sensitivity of 88% and specificity of 87%. Agreement between mPeDet-based classification and final clinical diagnosis was moderate (κ=0.69).</p><p><strong>Conclusion: </strong>Time-series-based evaluation of detrusor pressure during voiding provides additional clinically relevant information compared to conventional point-based urodynamic parameters. mPeDet may serve as a simple and reproducible complementary marker for the assessment of BOO, particularly in cases with diagnostic uncertainty.</p>","PeriodicalId":14466,"journal":{"name":"International Neurourology Journal","volume":"30 2","pages":"146-154"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13342838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Urodynamic Predictors of Urinary Urgency Improvement After Cystocele Repair.","authors":"Ju Hun Ahn, Joon Chul Kim, Jin Bong Choi, Jun Sung Koh, Young Kyu Han, Seong Joo Yang, Kang Jun Cho","doi":"10.5213/inj.2652102.051","DOIUrl":"10.5213/inj.2652102.051","url":null,"abstract":"<p><strong>Purpose: </strong>Overactive bladder (OAB) symptoms may improve following surgical correction of cystocele. This study aimed to evaluate changes in urgency, the primary symptom of OAB, and identify factors associated with improvement in urgency after surgical treatment for cystocele.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of medical records for patients who underwent surgical treatment for cystocele and had preoperative urgency measuring ≥3 on a 5-point urinary sensation scale. Patients were categorized into 2 groups based on their urgency status 3 months postsurgery: those with improved urgency and those without improvement. Improvement was defined as a reduction of 2 or more points on the scale following surgery. We compared preoperative clinical and urodynamic factors between the 2 groups.</p><p><strong>Results: </strong>A total of 137 patients were included in the study, with 98 (71.5%) showing improvement in urgency symptoms after surgery. The improved group had a significantly higher prevalence of preoperative urgency urinary incontinence (UUI) (62.2% vs. 30.8%, P=0.001) and bladder outlet obstruction (43.9% vs. 20.5%, P=0.011) compared to the nonimproved group. Urodynamic evaluations indicated that the detrusor pressure at maximum flow rate (PdetQmax) was significantly higher in the improved group than in the nonimproved group (P=0.004). Multivariate logistic regression analysis identified preoperative UUI, higher PdetQmax, and lower vaginal parity as independent predictors of improvement in urgency postoperatively.</p><p><strong>Conclusion: </strong>Preoperative UUI, higher PdetQmax, and lower vaginal parity were significant predictors of postoperative improvement in urgency. Both clinical and urodynamic factors may help identify patients with cystocele and preoperative urgency who are most likely to benefit from anatomical correction.</p>","PeriodicalId":14466,"journal":{"name":"International Neurourology Journal","volume":"30 2","pages":"163-171"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13342856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Urodynamic Bladder Outlet Obstruction on Bladder Trabeculation Grade in Patients With Benign Prostatic Hyperplasia: Retrospective Patient Cohort Study.","authors":"Sang Won So, Hyomyoung Lee, Gyumin Lee, Sung Yong Cho, Seong Jin Jeong, Seung-June Oh","doi":"10.5213/inj.2550362.181","DOIUrl":"10.5213/inj.2550362.181","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the correlation between bladder outlet obstruction (BOO) and bladder trabeculation in patients with benign prostatic hyperplasia (BPH).</p><p><strong>Methods: </strong>We analyzed data from consecutive BPH patients from July 2014 to June 2024, who underwent urodynamic study (UDS) and cystourethroscopy. The results of free uroflowmetry, filling cystometry, and pressure-flow study were analyzed to evaluate functional parameters. For anatomical parameters, bladder trabeculation grade, lateral lobe protrusion of prostate, and bladder neck elevation (BNE) measured in cystourethroscopy were used. BOO was defined as the BOO index of 40 or higher in UDS. Bladder trabeculation was graded using our previous studies.</p><p><strong>Results: </strong>Among total of 1,452 BPH patients, 1,028 patients had trabeculation on cystoscopy. Age, serum prostate-specific antigen, postvoid residual, total prostate volume, transition zone volume, terminal type detrusor overactivity, detrusor pressure at the maximal flow rate, bladder contractility index (BCI), and BOO index increased according to increase in bladder trabeculation. Multivariable logistic analysis showed that bladder trabeculation was significantly associated with age (odds ratio [OR], 1.05; P<0.001), kissing sign (OR, 1.55; P=0.007), BNE (OR, 1.76; P<0.001), detrusor overactivity (OR, 1.88; P=0.002), BCI (OR, 1.01; P=0.037), BOO (OR, 2.27; P<0.001). BOO had the greatest correlation with bladder trabeculation. In addition, BOO index showed a positive correlation (r=0.39, P<0.001) with bladder trabeculation. BOO index well distinguished between moderate trabeculation of grade 2 or higher in receiver operating characteristic analysis (area under curve=0.72, P<0.001).</p><p><strong>Conclusion: </strong>Our results showed that the severity of BOO is positively associated with the severity of bladder trabeculation.</p>","PeriodicalId":14466,"journal":{"name":"International Neurourology Journal","volume":"30 2","pages":"127-136"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13342841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urodynamic Study Revisited: An Evolving Tool in Functional Urology.","authors":"Jae Heon Kim","doi":"10.5213/inj.2652178.089","DOIUrl":"10.5213/inj.2652178.089","url":null,"abstract":"","PeriodicalId":14466,"journal":{"name":"International Neurourology Journal","volume":"30 2","pages":"83-85"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13342858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wearable Ultrasound Devices for Continuous Bladder Monitoring: Emerging Utility and Current Limitations in Neurourology.","authors":"Sehwan Kim, Aram Kim","doi":"10.5213/inj.2652030.015","DOIUrl":"10.5213/inj.2652030.015","url":null,"abstract":"<p><p>Monitoring bladder filling is crucial in patients with neurogenic lower urinary tract dysfunction, particularly for safe and timely clean intermittent catheterization. Wearable ultrasound devices have recently gained attention as potential aids for continuous bladder monitoring, but they differ fundamentally from traditional bladder scanners. While portable scanners directly measure postvoid residual volume in milliliters, first-generation wearable devices using amplitude mode (A-mode) ultrasound primarily monitor bladder fullness trends and provide threshold-based alerts rather than precise quantitative volume measurements. This narrative review examines wearable ultrasound technologies in neurourology, searching PubMed, Embase, IEEE Xplore, and Google Scholar for relevant clinical studies. Most available data come from small observational studies in pediatric populations. In children with functional voiding dysfunction (FVD), devices such as SENS-U achieved sensitivities of 85%-90% for detecting bladder fullness thresholds with good correlation to urodynamic measurements. However, performance in neurogenic bladder populations is concerning: a recent study in children with neurogenic bladder reported only 46% accuracy and 13% specificity using DFree, indicating unacceptably high false-positive rates. No prospective validation studies have been conducted in adults with spinal cord injury, multiple sclerosis, or those at risk for autonomic dysreflexia. Regulatory classifications vary significantly among devices: SENS-U holds Conformité Européenne marking as a Class IIa medical device for pediatric use, while DFree is marketed as a consumer wellness product without medical device approval. EdgeFlow UW20, which employs a deep learning-based automatic bladder contour detection, recently received Ministry of Food and Drug Safety approval in Korea as a digital medical device. Currently, evidence supports considering wearable bladder monitors only for pediatric FVD under medical supervision. For neurogenic bladder populations, these devices are not recommended for routine clinical use until population-specific validation studies demonstrate adequate diagnostic accuracy. The emergence of B-mode (brightness mode) deep learning-based devices may address the fundamental limitations of first-generation A-mode technology.</p>","PeriodicalId":14466,"journal":{"name":"International Neurourology Journal","volume":"30 2","pages":"95-104"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13342839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Music on Pain, Embarrassment, and Urodynamic Outcomes During Urodynamic Testing: A Randomized Controlled Trial.","authors":"Yasemin Özhanlı, Havva Bozdemir, Züleyha Şimşek Yaban, Nagihan Sarı, Cüneyd Özkürkçügil","doi":"10.5213/inj.2550262.131","DOIUrl":"10.5213/inj.2550262.131","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigated whether music affected pain, embarrassment, and urodynamic outcomes during invasive urodynamic testing.</p><p><strong>Methods: </strong>In this randomized controlled trial, 94 patients were assigned to a music group (n=49) or a control group (n=45). Patients in the music group listened to slow-tempo classical instrumental music at 40-60 dB, whereas those in the control group received standard care. The primary outcome was procedural pain, which was measured using a visual analogue scale at 3 stages: uroflowmetry, positioning on the examination table, and catheter insertion. Secondary outcomes included embarrassment and objective urodynamic parameters. Nonparametric methods were used because of the data distribution.</p><p><strong>Results: </strong>The music group reported lower pain during uroflowmetry (T1; P=0.022) and positioning on the examination table (T2; P=0.041), although the absolute reductions were small. Pain did not differ significantly between groups during catheter insertion (T3). No significant between-group differences were found in embarrassment or urodynamic parameters (P>0.05).</p><p><strong>Conclusion: </strong>Music may modestly reduce pain during some stages of invasive urodynamic testing, but it did not affect embarrassment or urodynamic outcomes. Because it is simple, safe, and low cost, music may be a useful supportive nursing intervention to improve patient comfort, although its clinical effect appears limited.</p>","PeriodicalId":14466,"journal":{"name":"International Neurourology Journal","volume":" ","pages":"118-126"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13342868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147365109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interobserver Agreement of Filling Cystometry Parameters in Children With Neurogenic Lower Urinary Tract Dysfunction.","authors":"Yunus Emre Genc, Faruk Arslan, Onur Can Ozkan, Osman Akyuz, Raziye Ergun, Ahmet Ozgur Guctas, Selcuk Yucel, Kamil Cam, Tufan Tarcan, Cagri Akin Sekerci","doi":"10.5213/inj.2652052.026","DOIUrl":"10.5213/inj.2652052.026","url":null,"abstract":"<p><strong>Purpose: </strong>Urodynamic studies (UDS) are the gold standard for evaluating pediatric lower urinary tract dysfunction (LUTD). However, previous studies have shown that the interpretation of cystometric findings may vary according to the observer's level of experience and the criteria used for evaluation. This study aimed to investigate interobserver differences in the reporting of cystometric parameters in children with spina bifida.</p><p><strong>Methods: </strong>Patients who underwent UDS between 2020 and 2025 for neurogenic LUTD secondary to spina bifida were retrospectively reviewed. Studies that did not reach 80% agreement for compliance with good urodynamic practice standards were excluded. Detrusor overactivity (DOA) and bladder compliance were independently evaluated by 4 pediatric urologists and 3 urologists experienced in neuro-urology. Agreement was assessed using Fleiss' kappa test.</p><p><strong>Results: </strong>A total of 100 children, including 53 females and 47 males, were included; the median age was 6.5 (range, 1-17) years. Agreement of at least 80% was reached in 86% of evaluations for DOA and 82% of evaluations for compliance. Based on the ratings of 7 observers, the Fleiss' kappa value was 0.60 for DOA, indicating moderate agreement, and 0.46 for bladder compliance, indicating weak agreement.</p><p><strong>Conclusion: </strong>This study demonstrated substantial interobserver variation in the interpretation of UDS, even among experienced centers and observers. Because UDS are essential for the diagnosis, treatment, and follow-up of patients with spina bifida, standardized criteria are needed to improve interobserver consistency in this patient group. Multicenter prospective studies involving observers with varying levels of experience are warranted to improve concordance in UDS reporting.</p>","PeriodicalId":14466,"journal":{"name":"International Neurourology Journal","volume":"30 2","pages":"155-162"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13342854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}