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Bladder wall thickness measured by CT can predict bladder outlet obstruction in men: a retrospective cohort study

  • Urology - Original Paper
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Abstract

Purpose

To evaluate whether bladder wall thickness (BWT) measured by CT can be used to predict bladder outlet obstruction in men with low urinary tract symptoms (LUTS).

Methods

From 2015 to 2018, a total of 120 men with lower urinary tract symptoms who underwent both urodynamic studies and CT tests of the lower abdomen or pelvis were involved. Bladder wall thickness values were measured by CT scanning.

Results

Based on the urodynamic studies, 120 men were categorized into two groups, including 70/120 men (58.3%) in the bladder outlet obstruction (BOO) group and 50/120 men (41.7%) in the non-BOO group. The mean BWT was thicker in the BOO group than in the non-BOO group (3.87 vs. 2.75 mm, p < 0.001). The mean maximum bladder capacity (MBC) was lower in the BOO group than in the non-BOO group (263.42 vs. 308.96 ml, p < 0.001). The mean detrusor pressure at maximum urinary flow rate (PdetQmax) was higher in the patients in the BOO group than in those in the non-BOO group (102.28 vs. 49.25 cmH2O, p < 0.001). The ROC curve showed that BWT was a good predictor with an AUC of 0.855 (95% CI 0.785–0.924, p < 0.001). At the cutoff value of 3.20 mm, the predictive sensitivity of BWT for BOO was 72.9%, and the specificity was 90%.

Conclusion

Increased bladder wall thickness was correlated with bladder outlet obstruction in men with LUTS. Bladder wall thickness measured by CT scans may be a noninvasive parameter to predict bladder outlet obstruction in men with LUTS.

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Availability of data and materials

The datasets used and analyzed during the current study are not publicly available due to the relevant data protection law but are available from the corresponding author on reasonable request. Data used in the present study were original medical records in Peking University People's Hospital. To access/use the original medical records, you would need administrative proposal consent for publication.

Abbreviations

AUC:

Area under the curve

BOO:

Bladder outlet obstruction

BOOI:

BOO index

BPH:

Benign prostatic hyperplasia

BWT:

Bladder wall thickness

CI:

Confidence interval

CT:

Computed tomography

DWT:

Detrusor wall thickness

IPP:

Intravesical prostatic protrusion

LUTs:

Lower urinary tract symptom

MBC:

Maximum bladder capacity

PdetQmax:

Detrusor pressure at maximum urinary flow rate

PV:

Prostate volume

PVR:

Postvoid residual urine volume

Qmax:

Maximum urinary flow rate

ROC:

Receiver operating characteristic

SMCs:

Smooth muscle cells

UDS:

Urodynamic studies

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Acknowledgements

We gratefully acknowledge Mr. Jingwen Chen and Mr. Yiran Sun in the Department of Urology to have performed all of the urodynamic tests in the past ten years in our center.

Funding

Funding was provided by National Natural Science Foundation of China (grant no. 81970660) with Kexin Xu as the recipient and Peking University People’s Hospital Research and Development Fund (grant no. RDY2021-16) with Huanrui Wang as the recipient.

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Author notes

  1. Zehua Ding and Huanrui Wang contributed equally to this work and should be considered co-first authors.

Authors and Affiliations

  1. Department of Urology, Peking University People’s Hospital, Beijing, China

    Zehua Ding, Weiyu Zhang, Hao Hu, Qi Wang & Kexin Xu

  2. Urology and Lithotripsy Center, Peking University People’s Hospital, Beijing, China

    Huanrui Wang

  3. Peking University Applied Lithotripsy Institute, Peking University, Beijing, China

    Huanrui Wang

Authors
  1. Zehua Ding
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  2. Huanrui Wang
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  3. Weiyu Zhang
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  4. Hao Hu
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  5. Qi Wang
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  6. Kexin Xu
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Contributions

ZD wrote the main manuscript, collected the data and analyzed the data; HW developed the project and got data acquisition, data analysis and data interpretation; KX got project development, data interpretation, manuscript writing; WZ got project development, data acquisition, data analysis, data interpretation; HH got project development, data interpretation; QW got project development, data interpretation; All authors read and approved the final manuscript.

Corresponding author

Correspondence to Kexin Xu.

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Conflict of interest

The authors declare that they have no competing interests.

Ethics approval

The study was conducted in accordance with the Declaration of Helsinki. The study did not require an ethical board approval because it was waived by Ethics Committee of Peking University Peoples Hospital because of the nature of retrospective study in line with international ethics norms.

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Not applicable.

Consent to participate

No informed consent was required, because the data are anonymized and the informed consent was waived by Ethics Committee of Peking University Peoples Hospital because of the nature of retrospective study in line with international ethics norms.

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Ding, Z., Wang, H., Zhang, W. et al. Bladder wall thickness measured by CT can predict bladder outlet obstruction in men: a retrospective cohort study. Int Urol Nephrol 55, 43–49 (2023). https://doi.org/10.1007/s11255-022-03361-8

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  • DOI: https://doi.org/10.1007/s11255-022-03361-8

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