Tzu Chi Medical Journal
Volume 21, Issue 2 , Pages 129-135, June 2009

Transabdominal Ultrasound Measurement of Detrusor Wall Thickness in Patients with Overactive Bladder

  • Hann-Chorng Kuo

      Affiliations

    • Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
    • Corresponding Author InformationCorresponding author. Department of Urology, Buddhist Tzu Chi General Hospital, 707, Section 3, Chung-Yang Road, Hualien, Taiwan
    • ,
  • Yi-Chou Chen

      Affiliations

    • Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
    • ,
  • Chia-Yen Chen

      Affiliations

    • Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
    • ,
  • Michael B. Chancellor

      Affiliations

    • Department of Urology, William Beaumont Hospital, Royal Oak, MI, USA

Received 21 November 2008; received in revised form 16 December 2008; accepted 24 December 2008.

Article Outline

Abstract 

Objective

To measure the detrusor wall thickness (DWT) in patients with overactive bladder (OAB) to determine whether it can be used as a biomarker for assessment in these patients.

Materials and Methods

Transabdominal sonography of the bladder using an 8-MHz probe to measure DWT was performed in patients with OAB dry, OAB wet and healthy controls. Bladder volume was determined by the summation of the voided volume and the postvoid residual. The DWT for a bladder volume less than 250 mL was further corrected to an equivalent volume of 250 mL and then compared among subgroups of men and women

Results

A total of 208 subjects were recruited, including 69 controls, 89 patients with OAB dry and 50 patients with OAB wet. There were 101 men and 107 women. Wide variations in the DWT were noted among the subgroups. After correction for bladder volume, DWT in the OAB dry and OAB wet groups was significantly higher in men (1.41 ± 0.30 mm and 1.50 ± 0.48 mm, respectively; p< 0.0001) but not in women (1.21 ± 0.36 mm and 1.32 ± 0.39 mm, respectively; p > 0.05) when compared to controls (men, 1.02 ± 0.24 mm; women, 1.11 ± 0.32 mm). Men with OAB dry had a significantly higher corrected DWT than women, but the corrected DWT showed no significant difference between men and women with OAB wet

Conclusion

DWT values in patients with OAB were increased in men but not in women, suggesting a difference in the underlying pathophysiology in men with OAB. Based on our results, we do not recommend using DWT as a biomarker for assessing OAB in women.

Keywords:  Bladder outlet obstruction , Bladder wall , Overactive bladder , Ultrasound

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

  1. Milson I , Abrams P , Cardozo L , Roberts RG , Thuroff J , Wein AJ . How widespread are the symptoms of an overactive bladder and how are they managed? A population based prevalence study . BJU Int . 2001;87:760–766
  2. Hashim H , Abrams P . In the bladder a reliable witness for predicting detrusor overactivity? . J Urol . 2006;175:191–194
  3. Manieri C , Carter SS , Romano G , Trucchi A , Valenti M , Tubaro A . The diagnosis of bladder outlet obstruction in men by ultrasound measurement of bladder wall thickness . J Urol . 1998;159:761–765
  4. Hakenberg OW , Linne C , Manseck A , Worth MP . Bladder wall thickness in normal adults and men with mild lower urinary tract symptoms and benign prostatic enlargement . Neurourol Urodyn . 2000;19:585–593
  5. Oelke M , Hofner K , Jonas U , de la Rosette J , Ubbink D , Wijkstra H . Diagnostic accuracy of noninvasive tests to evaluate bladder outlet obstruction in men: detrusor wall thickness, uroflowmetry, postvoid residual urine, and prostate volume . Eur Urol . 2007;52:827–834
  6. Kelly CE . The relationship between pressure flow studies and ultrasound-estimated bladder wall mass . Rev Urol . 2005;7:S29–S34
  7. Robinson D , Anders K , Cardozo L , Bidmead J , Toozs-Hobson P , Khullar V . Can ultrasound replace ambulatory urodynamics when investigating women with irritative urinary symptoms? . BJOG . 2002;109:145–148
  8. Kessler TM , Gerber R , Burkhard FC , Studer UE , Danuser H . Ultrasound assessment of detrusor thickness in men— can it predict bladder outlet obstruction and replace pressure flow study? . J Urol . 2006;175:2170–2173
  9. Yeung CK , Screedhar B , Leung YF , Sit KY . Correlation between ultrasonographic bladder measurements and urodynamic findings in children with recurrent urinary tract infection . BJU Int . 2007;99:651–655
  10. Yeung CK , Screedhar B , Leung YF , Metreweli C . Ultrasound bladder measurements in patients with primary nocturnal enuresis: a urodynamic and treatment outcome correlation . J Urol . 2004;171:2589–2594
  11. Oelke M , Hofner K , Jonas U , Ubbink D , de la Rosette J , Wijkstra H . Ultrasound measurement of detrusor wall thickness in healthy adults . Neurourol Urodyn . 2006;25:308–317
  12. Blatt AH , Titus J , Chan L . Ultrasound measurement of bladder wall thickness in the assessment of voiding dysfunction . J Urol . 2008;179:2275–2278
  13. Khullar V , Cardozo LD , Salvatore S , Hill S . Ultrasound: a noninvasive screening test for detrusor instability . Br J Obstet Gynaecol . 1996;103:904–908
  14. Abrams P , Cardozo L , Fall M , et al.   The standardization of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society . Neurourol Urodynam . 2002;21:167–178
  15. Ouslander JG . Mangement of overactive bladder . N Engl J Med . 2004;350:786–799
  16. Hyman MJ , Groutz A , Blaivas JG . Detrusor instability in men: correlation of lower urinary tract symptoms with urodynamic findings . J Urol . 2001;166:550–552
  17. Andersson KE . Treatment-resistant detrusor overactivity— underlying pharmacology and potential mechanisms . Int J Clin Pract Suppl . 2006;151:8–16
  18. Kuo HC . Videourodynamic characteristics and lower urinary tract symptoms of female bladder outlet obstruction . Urology . 2005;66:1005–1009
  19. Muller L , Bergstrom T , Hellstrom M , Svensson E , Jacobsson B . Standardized ultrasound method for assessing detrusor muscle thickness in children . J Urol . 2000;164:134–138

PII: S1016-3190(09)60024-0

doi:10.1016/S1016-3190(09)60024-0

Tzu Chi Medical Journal
Volume 21, Issue 2 , Pages 129-135, June 2009

Article Tools