{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T20:44:36Z","timestamp":1771706676974,"version":"3.50.1"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2022,8,2]],"date-time":"2022-08-02T00:00:00Z","timestamp":1659398400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Curr Urol"],"published-print":{"date-parts":[[2024,3]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Atypical Congenital Obstructive Urethral Lesions (ACOUL) are uncommon causes of urethral obstruction in children. They include Cobb\u2019s collar or Moorman\u2019s ring, Type III posterior urethral valve (PUV), congenital urethral narrowing and anterior urethral valves. This study is aimed to evaluate the knowledge and current practice amongst clinicians attending to ACOUL. An international online case based questionnaire was performed.<\/jats:p>\n <\/jats:sec>\n \n Materials and methods<\/jats:title>\n A survey was administered to members of international urological societies. It included 22 clinical questions on cases with ACOUL (14 questions suitable for statistical analysis) using cases of Type I PUV as controls. Two sets of paired questions evaluated change in opinion(s) after additional information was provided.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n One hundred twenty-one participants responded with 71% reporting exposure of less than 5 cases per annum. In questions regarding diagnosis between 11.6% (14\/121) and 21.5% (26\/121) of participants identified the ACOUL as PUV. Among them, 66% of respondents agreed on ACOUL\u2019s causative role in urethral obstruction. Gini coefficient was consistently lower for ACOUL compared to PUV: diagnosis (mean 0.33 vs. 0.44) and prognosis (0.23 vs. 0.43). High intra-rater concordance (kappa 0.420.57) was observed for paired questions\u2013a mean of 5.79% (7.44% and 4.13% for questions 10 and 12, 16 and 17, respectively) of participants changed their answers from an alternate diagnosis to the correct diagnosis of ACOUL after viewing endoscopic images. High variation in management of ACOUL was noted (Gini 0.51).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This global snapshot survey identified substantial inconsistency among clinicians dealing with ACOUL. Although rarely encountered in clinical practice, better overall education of ACOUL is warranted.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/cu9.0000000000000092","type":"journal-article","created":{"date-parts":[[2022,3,3]],"date-time":"2022-03-03T12:12:20Z","timestamp":1646309540000},"page":"12-17","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Lack of consensus in atypical congenital obstructive urethral lesions in children: Snapshot of the web-based ObsCUre (obstruction to the child urethra) study"],"prefix":"10.1097","volume":"18","author":[{"given":"Rachel","family":"Ng","sequence":"first","affiliation":[{"name":"Department of Paediatric Urology, John Hunter Children\u2019s Hospital, New Lambton Heights, NSW, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed","family":"Adam","sequence":"additional","affiliation":[{"name":"Division of Urology, University of the Witwatersrand, Johannesburg, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathan","family":"Poppleton","sequence":"additional","affiliation":[{"name":"Klerksdorp Hospital, Klerksdorp, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Oldmeadow","sequence":"additional","affiliation":[{"name":"CREDITSS Service, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aniruddh V.","family":"Deshpande","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2022,8,2]]},"reference":[{"key":"bib1-20250821","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/S0022-5347(17)74179-1","article-title":"Congenital obstruction of the posterior urethra","volume":"3","year":"1919","journal-title":"J 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Urology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/CU9.0000000000000092","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T16:02:28Z","timestamp":1755792148000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/CU9.0000000000000092"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,2]]},"references-count":12,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.1097\/cu9.0000000000000092","relation":{},"ISSN":["1661-7649"],"issn-type":[{"value":"1661-7649","type":"print"}],"subject":[],"published":{"date-parts":[[2022,8,2]]}}}