title: Establishment of the novel cystoscopic classification for bladder trabeculation of neurogenic bladder.
abstract: OBJECTIVE
  To establish a cystoscopic grading system for trabeculation of neurogenic bladders.
  
  
  METHODS
  A total of 140 neurogenic bladder patients who had undergone both fluoroscopic urodynamic study and cystoscopic examination were retrospectively reviewed. Cystoscopic images were categorized into 4 grades according to the formation of the muscle bundle layer and height-to-width ratio of the muscle bundle: 0 (none), 1 (mild), 2 (moderate), and 3 (severe). Test-retest reliability and interobserver reliability were assessed. Cystoscopic grade of the trabeculated bladder was correlated with urodynamic results and the fluoroscopic grades of trabeculation.
  
  
  RESULTS
  The test-retest reliability showed almost perfect agreement with all levels of Cronbach alpha ranging from 0.925 to 0.970. The intraclass correlation coefficient was 0.986, indicative of an almost perfect level of interobserver reliability. The grading system showed clinical significance by correlation with urodynamic parameters (Qmax, P value = .016; postvoid residual, P value <.001; bladder outlet obstruction index, P value = .002). Cystoscopic grades correlated moderately well with fluoroscopic grades, showing comparable clinical significance with fluoroscopic grades.
  
  
  CONCLUSIONS
  Our results showed that this novel cystoscopic classification of bladder trabeculation was highly reliable.
authors.affiliation: Department of Urology, Seoul National University Hospital, Seoul, South Korea.
authors.forename: Jae Hyun
authors.initials: JH
authors.lastname: Jung
authors.affiliation: Department of Urology, SMG-SNU Boramae Medical Center, Seoul, South Korea.
authors.forename: Sung Yong
authors.initials: SY
authors.lastname: Cho
authors.affiliation: Department of Biostatistics, Florida International University, Miami, FL.
authors.forename: Changwon
authors.initials: C
authors.lastname: Yoo
authors.affiliation: Department of Urology, Seoul National University Hospital, Seoul, South Korea. Electronic address: sjo@snu.ac.kr.
authors.forename: Seung-June
authors.initials: SJ
authors.lastname: Oh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003558:Cystoscopy / Q000379:methods*; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D001743:Urinary Bladder / Q000473:pathology; D001748:Urinary Bladder Neck Obstruction / Q000473:pathology; D001750:Urinary Bladder, Neurogenic / Q000145:classification* / Q000175:diagnosis*; D014563:Urodynamics; D055815:Young Adult