Diagnoses and Treatment Recommendations-Interrater Reliability of Uroflowmetry in People with Multiple Sclerosis

Uroflowmetry (UF) is an established procedure in urology and is recommended before further investigations of neurogenic lower urinary tract dysfunction (NLUTD). Some authors even consider using UF instead of urodynamics (UD). Studies on the interrater reliability of UF regarding treatment recommenda...

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Published in:Biomedicines 2024-07, Vol.12 (7), p.1598
Main Authors: Jaekel, Anke K, Rieger, Julia, Butscher, Anna-Lena, Möhr, Sandra, Schindler, Oliver, Queissert, Fabian, Hofmann, Aybike, Schmidt, Paul, Kirschner-Hermanns, Ruth, Knüpfer, Stephanie C
Format: Article
Language:English
Subjects:
Agreements
Bladder
bladder disorder
Botulinum toxin
Feedback
Medical diagnosis
Medical history
Multiple sclerosis
neurogenic
Neuromodulation
Sphincter
Ultrasonic imaging
Urinary tract
Urine
Urogenital system
Urology
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Summary:Uroflowmetry (UF) is an established procedure in urology and is recommended before further investigations of neurogenic lower urinary tract dysfunction (NLUTD). Some authors even consider using UF instead of urodynamics (UD). Studies on the interrater reliability of UF regarding treatment recommendations are rare, and there are no relevant data on people with multiple sclerosis (PwMS). The aim of this study was to investigate the interrater reliability (IRR) of UF concerning diagnosis and therapy in PwMS prospectively. UF of 92 PwMS were assessed by 4 raters. The diagnostic criteria were normal findings (NFs), detrusor overactivity (DO), detrusor underactivity (DU), detrusor-sphincter dyssynergia (DSD) and bladder outlet obstruction (BOO). The possible treatment criteria were as follows: no treatment (NO), catheter placement (CAT), alpha-blockers, detrusor-attenuating medication, botulinum toxin (BTX), neuromodulation (NM), and physiotherapy/biofeedback (P/BF). IRR was assessed by kappa (κ). κ of diagnoses were NFs = 0.22; DO = 0.17; DU = 0.07; DSD = 0.14; and BOO = 0.18. For therapies, the highest κ was BTX = 0.71, NO = 0.38 and CAT = 0.44. There is a high influence of the individual rater. UD should be subject to the same analysis and a comparison should be made between UD and UF. This may have implications for the value of UF in the neuro-urological management of PwMS, although at present UD remains the gold standard for the diagnostics of NLUTD in PwMS.
ISSN:2227-9059
2227-9059
DOI:10.3390/biomedicines12071598