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Does bladder wall thickness decrease when obstruction is resolved?

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Abstract

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.

Methods

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.

Results

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).

Conclusions

If obstruction is resolved, bladder wall thickness decreases. Preoperatively elevated residual urine may increase the risk of persistent obstruction after urethrolysis.

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Conflicts of interest

None.

Ethical approval

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.

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Authors and Affiliations

  1. Urogynaecology, Department of Gynaecology, University Hospital and University of Bern, Effingerstrasse 102, CH 3010, Bern, Switzerland

    Annette Kuhn, Sonja Brandner & Luigi Raio

  2. Effingerzentrum Bern, Effingerstr. 45, Bern, Switzerland

    Peter Kuhn

  3. King’s College, London, UK

    Dudley Robinson

Authors
  1. Annette Kuhn
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  2. Sonja Brandner
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  3. Peter Kuhn
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  4. Dudley Robinson
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  5. Luigi Raio
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Corresponding author

Correspondence to Annette Kuhn.

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Kuhn, A., Brandner, S., Kuhn, P. et al. Does bladder wall thickness decrease when obstruction is resolved?. Int Urogynecol J 23, 1239–1244 (2012). https://doi.org/10.1007/s00192-011-1642-6

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  • DOI: https://doi.org/10.1007/s00192-011-1642-6

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