Does bladder wall thickness decrease when obstruction is resolved?
- 150 Downloads
Introduction and hypothesis
The aim of the current study was to determine if sonographic bladder wall thickness diminishes after symptomatic obstruction is resolved in female patients after stress incontinence surgery.
Between December 2008 and December 2010, 62 female patients with symptomatic bladder outlet obstruction, as defined by Blaivas, who had undergone prior surgery for urinary stress incontinence were included in the study. The patients’ history was taken and symptoms were noted. Patients underwent gynaecological examination, and multichannel urodynamic assessment was performed. Vaginal sonographic assessment of the bladder wall thickness (BWT) was performed before and after urethrolysis.
62 patients were included in this study, 55 of whom had undergone suburethral sling insertion and seven had Burch colposuspension. Postoperatively, BWT decreased significantly from 9.1 mm ± 2.1 to 7.6 mm ± 2.2 (p < 0.0001). In seven patients, obstruction was still unresolved postoperatively; of these, two had undergone a retropubic sling insertion and two had a Burch colposuspension. An ROC curve analysis showed a significant positive association between residual urine and persistent obstruction before surgery (AUC 0.76, 95%CI 0.58–0.94; p < 0.05).
If obstruction is resolved, bladder wall thickness decreases. Preoperatively elevated residual urine may increase the risk of persistent obstruction after urethrolysis.
KeywordsSonographic bladder wall thickness Urodynamic obstruction Urethrolysis Surgery for urodynamic stress incontinence
Conflicts of interest
Ethical approval was given by the Kantonale Ethikkommission Bern (KEK), President: Prof. Niklaus Tüller. Registration number is E 01-04-10 and this study belongs to the quality control rules of our institution.
- 3.Glazener CM, Lapitan MC (2002) Urodynamic investigations for management of urinary incontinence in adults. Cochrane Database Syst Rev 3:CD 003195Google Scholar
- 6.Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, van Kerrebroek P, Victor A, Wein A (2002) The standardisation of terminology of lower urinary tract function: report from the standardisation sub-committee of the international continence society. Neurourol Urodyn 21:167–178PubMedCrossRefGoogle Scholar
- 15.Ward KL, Hilton P, Browning J (2000) A randomized trial of colposuspension and tension-free vaginal tape for primary stress incontinence. Neurourol Urodyn 19:386–388Google Scholar
- 32.Kuhn A, Genoud S, Robinson D, Herrmann G, Guenthert AR, Brandner S, Raio L (2010) Sonographic transvaginal bladder wall thickness: does the measurement discriminate between urodynamic diagnoses? Neurourol Urodyn 26:1–4Google Scholar