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International Urogynecology Journal

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01-11-2010 | Original Article

Ultrasound measurement of bladder wall thickness in different forms of detrusor overactivity

Authors: Maurizio Serati, Stefano Salvatore, Elena Cattoni, Marco Soligo, Antonella Cromi, Fabio Ghezzi

Published in: International Urogynecology Journal | Issue 11/2010

Abstract

Introduction and hypothesis

Aims of this study were to compare the ultrasound measurement of bladder wall thickness (BWT) in women with different urodynamic diagnosis and to correlate BWT to the different urodynamic findings of detrusor overactivity (DO).

Methods

Two hundred forty seven women with urinary symptoms have been prospectively enrolled. Urodynamics and transvaginal ultrasound BWT were performed. Patients were divided into four urodynamic subgroups. BWT of women with DO was compared with the BWT of any other subgroup.

Results

Women with DO had a BWT value significantly higher (p < 0.0001). A cut-off of 6.5 mm for BWT had a positive predictive value of 100% for all DO. We use ROC curves to analyze the BWT for urgency urinary incontinence (AUC 0.645 95% CI 0.57–0.72) and the BWT for “pure DO” (AUC 0.702 95% CI 0.64–0.76) and for “all DO” (AUC 0.704 95% CI 0.64–0.77) vs other urodynamic diagnoses.

Conclusions

The ultrasound BWT showed a highly significant association with DO. However, the performance of this test cannot currently replace urodynamic testing.

Abrams P, Andersson KE, Birder L, Brubaker L, Cardozo L, Chapple C et al (2009) Recommendations of the international scientific committee: Evaluation and treatment of urinary incontinence, pelvic organ prolapse and faecal incontinence. In: Abrams P, Cardozo L, Khoury S, Wein A (eds) Incontinence, 4rd international consultation on incontinence. Health, Paris, pp 1784–1787

Nwosu CR, Khan KS, Chien PF, Honets MR (1998) Is real-time ultrasonic bladder volume estimation reliable and valid? A systematic overview. Scand J Urol Nephrol 32:325–330CrossRefPubMed

Gehrich A, Stany MP, Fischer JR, Buller J, Zahn CM (2007) Establishing a mean postvoid residual volume in asymptomatic perimenopausal and postmenopausal women. Obstet Gynecol 110:827–832PubMed

Choe JH, Lee JY, Lee KS (2007) Accuracy and precision of a new portable ultrasound scanner, the BME-150A, in residual urine volume measurement: a comparison with the bladderscan BVI 3000. Int Urogynecol J Pelvic Floor Dysfunct 18:641–644CrossRefPubMed

Haylen BT, Frazer MI, MacDonald JH (1989) Assessing the effectiveness of different urinary catheters in emptying the bladder: an application of transvaginal ultrasound. Br J Urol 64:353–356CrossRefPubMed

Tunn R, Schaer G, Peschers U, Bader W, Gauruder A, Hanzal E et al (2005) Updated recommendations on ultrasonography in urogynecology. Int Urogynecol J Pelvic Floor Dysfunct 16:236–241CrossRefPubMed

Dietz HP (2004) Ultrasound imaging of the pelvic floor. Part I: two dimensional aspects. Ultrasound Obstet Gynecol 23:80–92CrossRefPubMed

Dietz HP, Wilson PD, Clarke B (2001) The use of perineal ultrasound to quantify levator activity and teach pelvic floor muscle exercises. Int Urogynecol J Pelvic Floor Dysfunct 12:166–168CrossRefPubMed

Braekken IH, Majida M, Ellstrom-Engh M, Dietz HP, Umek W, Bø K (2008) Test-retest and intra-observer repeatability of two-, three- and four-dimensional perineal ultrasound of pelvic floor muscle anatomy and function. Int Urogynecol J Pelvic Floor Dysfunct 19:227–235CrossRefPubMed

10.

Dietz HP, Wilson PD (1999) The influence of bladder volume on the position and mobility of the urethrovesical junction. Int Urogynecol J Pelvic Floor Dysfunct 10:3–6CrossRefPubMed

11.

Khullar V, Salvatore S, Cardozo L, Bourne TH, Abbott D, Kelleher C (1994) A novel technique for measuring bladder wall thickness in women using transvaginal ultrasound. Ultrasound Obstet Gynecol 4:220–223CrossRefPubMed

12.

Khullar V, Cardozo L, Salvatore S, Hill S (1996) Ultrasound: a noninvasive screening test for detrusor instability. BJOG 103:904–908CrossRef

13.

Robinson D, Anders K, Cardozo L, Bidmead J, Toozs-Hobson P, Khullar V (2002) Can ultrasound replace ambulatory urodynamics when investigating women with irritative urinary symptoms? BJOG 109:145–148CrossRefPubMed

14.

Minardi D, Piloni V, Amadi A, El Asmar Z, Milanese G, Muzzonigro G (2007) Correlation between urodynamics and perineal ultrasound in female patients with urinary incontinence. Neurourol Urodyn 26:176–182CrossRefPubMed

15.

Blatt AH, Titus J, Chan L (2008) Ultrasound measurement of bladder wall thickness in the assessment of voiding dysfunction. J Urol 179:2275–2278CrossRefPubMed

16.

Lekskulchai O, Dietz HP (2008) Detrusor wall thickness as a test for detrusor overactivity in women. Ultrasound Obstet Gynecol 32:535–539CrossRefPubMed

17.

Salvatore S, Serati M, Digesu GA, Triacca P, Uccella S, Khullar V et al (2008) Efficacy of tolterodine in relation to different urodynamic findings of detrusor overactivity. Int Urogynecol J Pelvic Floor Dysfunct 19:701–704CrossRefPubMed

18.

Serati M, Salvatore S, Uccella S, Cromi A, Khullar V, Cardozo L et al (2008) Urinary incontinence at orgasm: relation to detrusor overactivity and treatment efficacy. Eur Urol 54:911–915CrossRefPubMed

19.

Bump RC, Mattiasson A, Bo K, Brubaker LP, DeLancey JO, Klarskov P et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor disfunction. Am J Obstet Gynecol 175:10–17CrossRefPubMed

20.

Schafer W, Abrams P, Liao L, Mattiasson A, Pesce F, Spangberg A et al (2002) Good urodynamic practices: uroflowmetry, filling cystometry, and pressure-flow studies. Neurourol Urodyn 21:261–274CrossRefPubMed

21.

Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J et al (2009) An international urogynecological association (IUGA)/international continence society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J Pelvic Floor Dysfunct. doi:10.1007/s00192-009-0976-9

22.

Haylen BT (1989) Residual urine volumes in a normal female population: application of transvaginal ultrasound. Br J Urol 64:347–349CrossRefPubMed

23.

Kuo HC (2009) Measurement of detrusor wall thickness in women with overactive bladder by transvaginal and transabdominal sonography. Int Urogynecol J Pelvic Floor Dysfunct 20:1293–1299CrossRefPubMed

24.

Muller L, Bergstrom T, Hellstrom M, Svensson E, Jacobsson B (2000) Standardized ultrasound method for assessing detrusor muscle thickness in children. J Urol 164:134–138CrossRefPubMed

25.

Chung SD, Chiu B, Kuo HC, Chuang YC, Wang CC, Guan et al (2009) Transabdominal ultrasonography of detrusor wall thickness in women with overactive bladder. BJU Int 105:668–672CrossRefPubMed

26.

Panayi DC, Khullar V, Fernando R, Tekkis P (2010) Transvaginal ultrasound measurement of bladder wall thickness: a more reliable approach than transperineal and transabdominal approaches. BJU Int. doi:10.1111/j.1464-410x.2010.09367.x

27.

Latthe PM, Champaneria R, Khan KS (2010) Systematic review of the accuracy of ultrasound as the method of measuring bladder wall thickness in the diagnosis of detrusor overactivity. Int Urogynecol J Pelvic Floor Dysfunct. doi:10.1007/s00192-010-1144-y

28.

Oelke M (2010) International consultation on incontinence-research society (ICI-RS) report on non-invasive urodynamics: the need of standardization of ultrasound bladder and detrusor wall thickness measurements to quantify bladder wall hypertrophy. Neurourol Urodyn 29:634–639CrossRefPubMed

Title: Ultrasound measurement of bladder wall thickness in different forms of detrusor overactivity
Authors: Maurizio Serati
Stefano Salvatore
Elena Cattoni
Marco Soligo
Antonella Cromi
Fabio Ghezzi
Publication date: 01-11-2010
Publisher: Springer-Verlag
Published in: International Urogynecology Journal / Issue 11/2010
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-010-1194-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Ultrasound measurement of bladder wall thickness in different forms of detrusor overactivity

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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