BERKELEY, CA (UroToday.com) - Ultrasonography has been increasingly used in the assessment of lower urinary tract conditions. In this study, we tested the hypothesis that ultrasound-estimated bladder weight (UEBW) correlates to urodynamic diagnoses in women with lower urinary tract symptoms (LUTS), especially detrusor under activity (DU) and bladder outflow obstruction (BOO).
Adult women referred to the urodynamics suite for investigation of LUTS were enrolled. After urodynamics, the portable BladderScan® BVM 6500 device was used to calculate bladder wall thickness (BWT) and UEBW according to a standardized protocol. Patients were categorized according to urodynamic findings. Women with normal investigations, despite symptoms for which they were referred, were used as controls. UEBW and BWT measurements were compared between groups and controls, p-values < 0.05 were considered statistically significant.
In total, 187 women were enrolled. Among these, 30 women had normal urodynamics and served as the controls for comparisons with the other urodynamic groups. Of these 30 women, 15 were referred with complaints of SUI, 3 with recurrent lower urinary tract infections and 12 with frequency/urgency, without incontinence.
UEBW was significantly lower in 25 patients with DU as the only urodynamic diagnosis (2 women with DU and SUI and 1 with DU and OD were not included in this group) compared to patients with a urodynamically normal detrusor, (39.3±3.0g vs. 45.7±3.1g, p < 0.001). BWT was also significantly different between patients with a urodynamic diagnosis of DU and controls. Significant differences were also noted between controls and patients with BOO, with or without DO (45.7±3.1g vs 52.1±3.9g and 52.3±6.2g respectively, p < 0.001 for both comparisons). Patients with BOO, with or without DO, also had significantly thicker bladder walls compared to patients with normal urodynamics. The difference in terms of UEBW between controls and patients with detrusor overactivity (DO) was not statistically significant (45.7±3.1g vs 45.3±3.0, p > 0.05). BWT also did not show statistical difference in this group of patients. This was also the case for both UEBW and BWT, for patients with SUI.
Significantly reduced UEBW in female patients with DU, and significantly increased UEBW in cases of BOO were shown in this research. The finding of significantly increased bladder weight in DO was not confirmed in this study. The clinical implications of our observations are not known. Given that bladder weight is reduced in DU, for example, it may be possible to use it in the future to diagnose DU and predict voiding difficulties in women undergoing incontinence surgery. We also need to establish normal values for asymptomatic and symptomatic women with different pathophysiologic findings. In conclusion, our data show that UEBW is a promising tool and automated measurement seems quite practical.
Anastasios Athanasopoulos, MD, PhD as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.
Department of Urology
Patras University Hospital
38 Papadiamantopoulou Street
Patras 26225 Greece