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11–14 APRIL, 2018, HELSINKI, FINLAND
08:55–08:58
S5-2 (PP)
DIAGNOSTIC ACCURACY OF VOIDING DYSFUNCTION
PATTERNS AS A PREDICTIVE TOOL OF VESICOURETERAL
REFLUX RESOLUTION AFTER FIRST ENDOSCOPIC
TREATMENT
Agustín SERRANO-DURBÁ, José A MARCH, Alba POLO, Povo IVAN,
Mari Angeles CONCA and Carlos DOMÍNGUEZ
La Fe Universitarian Hospital, Pediatric Urology Unit, Valencia, SPAIN
PURPOSE
To design a classification of dysfunctional voiding patterns associated with vesicoureteral reflux in
children, to evaluate the diagnostic performance of it and compare it with the existing classification.
MATERIAL AND METHODS
Cross-sectional ambispective study of 48 children with vesicoureteral reflux treated between
January 2013 and February 2015. Those with previous endoscopic treatment, age <3 years,
anatomical or neurological abnormalities and a history of urethroplasty or major abdominal surgery
were excluded. Demographic, anatomical, surgical and noninvasive urodynamic variables (voiding
diary, uroflowmetry with electromyography, residual urine and bladder wall thickness) were col-
lected. The outcome variable was the correctness of reflux (by isotopic cystography) three months
after the endoscopic treatment. A classification of voiding patterns was performed taking into ac-
count the most relevant variables for the outcome and diagnostic performance was evaluated finally
compared with the Van Batavia et al dysfunctional voiding classification1.
RESULTS
Mean age of the sample was 6.8 +/- 2.28 years. The rate of reflux correction after the first treatment
was 77 %. All urodynamic variables were included in the classification, which correctly identified
75 % of our sample, with sensitivity of 87.8 %, specificity 46.6 %, positive predictive value (PPV)
78.3 % and negative predictive value (NPV) 63,6 %. Using Van Batavia et al classification: sensitiv-
ity 32,4 %, specificity 54,55 %, PPV 70,59 %, NPV 19,35 %.
CONCLUSIONS
Our classification shows good sensitivity and better predictive values of the result after first endo-
scopic treatment and it can be compared with the Van Batavia et al classification.