The bladder contractility and bladder outlet obstruction indices in children. Results of a global Delphi consensus study.

Abstract

This Delphi study was planned to examine global expert consensus with regard to utility, accuracy, and categorization of Bladder Contractility Index (BCI), Bladder Outlet Obstruction Index (BOOI), and the related evidence. This manuscript deals with children and follows previous manuscripts reporting on adult men and women. Eighteen experts were invited to answer the two-round survey including threefoundation questions and foursurvey questions. Consensus was defined as ≥75% agreement. The ordinal scale (0-10) in Round 1 was classified into "strongly agree,""agree,""neutral,""disagree," and "strongly disagree"for the final round. A systematic search for evidence was conducted for therapeutic studies that have examined outcome stratified by the indices in children. Eleven experts participated in the survey with 100% completion. Consensus was not noted with regard to any of the questions. There was a general trend toward disagreement with the utility of the BCI and BOOI in children. Systematic search yielded onepublication pertaining the value of the indices in predicting long-term outcome in boys treated for posterior urethral valves. This global Delphi survey of experts showed a general disinclination to use numerical indices for bladder contractility and bladder outflow obstruction in children. There is very little data on the use of the BCI and BOOI indices in children. The establishment of urodynamic indices in children might help refine the treatment of functional urological disorders in children.