The role of ultrasound-estimated bladder-wall thickness in the prediction of detrusor overactivity in patients with irritative lower urinary tract symptoms - Abstract

Objective: To explore the specificity and sensitivity of increased bladder wall thickness as measured by transabdominal ultrasonography (TAU) for diagnosing detrusor overactivity (DO) in patients with lower urinary tract symptoms (LUTS) compared to the results of filling cystometry as a gold-standard diagnostic procedure.

Methods: This prospective study included 60 patients who were neurologically free with irritative LUTS. The study included 40 females and 20 males. Patients were divided into 2 groups. Group 1 included 40 patients with urodynamic evidence of DO and Group 2 (control) included 20 patients with normal urodynamic studies. All patients were submitted to a history, clinical examination, urine analysis and culture, blood chemistry, and pelviabdominal ultrasound.

Results: The mean age of Group 1 and Group 2 was 22.4 ± 2.4 and 27.6 ± 2.1 years, respectively. All patients had urgency. While 25% of patients in Group 1 had urge incontinence, no patients in Group 2 had urge incontinence. Those in Group 1 (65%) had nocturnal enuresis compared to 10% in Group 2; more than 1 patient had more than 1 complaint. The mean bladder-wall thickness as measured by TAU was significantly higher in Group 1 (5.2 ± 0.27 mm) than in Group 2 (2.8 ± 0.47 mm) (p < 0.001).

Conclusion: Transabdominal ultrasound is a sensitive diagnostic technique when predicting DO in patients with LUTS. This technique is noninvasive and easily performed in an office setting with negligible risks. Further studies are required to validate the findings of this study before this technique can be recommended as a primary diagnostic tool for DO.

KEYWORDS: Detrusor overactivity, bladder wall thickness, transabdominal ultrasound, urodynamics

CORRESPONDENCE: Sabri M Khaled, MD, Assistant Professor of Urology, Al-Azhar University, Eldarassa, Cairo, Egypt ( )

CITATION: UroToday Int J. 2012 October;5(5):art 48.


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