Functional Ultrasound: Assessment of the Weight and Thickness of the Detrusor

  • Cosimo De NunzioEmail author
  • Fabrizio Presicce
  • Andrea Tubaro


Lower urinary tract symptoms (LUTS) are a clinical condition commonly found in men over 50 years and also tend to rise progressively with age. Because of increased life expectancy, the number of patients with LUTS and the relative costs of diagnosis and treatment are still growing in Western countries [1]. LUTS may include voiding and storage urinary symptoms or a combination of both, and they may be considered a consequence of benign prostatic obstruction (BPO) with its related effect on detrusor function [2, 3].


Benign Prostatic Hyperplasia Lower Urinary Tract Symptom Detrusor Overactivity Bladder Outlet Obstruction Bladder Volume 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

Video 36.1

Detrusor wall thickness assessment (Oelke’s technique) (MP4 102980 kb)

Video 36.2

Bladder wall thickness assessment (Tubaro’s technique) (MP4 81863 kb)

Video 36.3

Detrusor wall thickness modifications according bladder filling volume (MP4 19625 kb)


  1. 1.
    Abrams P, Chapple C, Khoury S et al (2009) Evaluation and treatment of lower urinary tract symptoms in older men. J Urol 181:1779CrossRefPubMedGoogle Scholar
  2. 2.
    De Nunzio C, Autorino R, Bachmann A et al (2014) The diagnosis of benign prostatic obstruction: development of a clinical nomogram. Neurourol Urodyn. doi: 10.1002/nau.22705 Google Scholar
  3. 3.
    Abrams P, Chapple C, Khoury S, Roehrborn C, de la Rosette J, Committee IS (2009) Evaluation and treatment of lower urinary tract symptoms in older men. J Urol 181:1779–1787CrossRefPubMedGoogle Scholar
  4. 4.
    McConnell JD (1994) Why pressure-flow studies should be optional and not mandatory for evaluating men with benign prostatic hyperplasia. Urology 44:156–158CrossRefPubMedGoogle Scholar
  5. 5.
    AUA Practice Guidelines Committee (2003) AUA guideline on management of benign prostatic hyperplasia (2003). Chapter 1: Diagnosis and treatment recommendations. J Urol 170(2 Pt 1):530–547Google Scholar
  6. 6.
    Oelke M, Kirschner-Hermanns R, Thiruchelvam N, Heesakkers J (2012) Can we identify men who will have complications from benign prostatic obstruction (BPO)? ICI-RS 2011. Neurourol Urodyn 31:322–326CrossRefPubMedGoogle Scholar
  7. 7.
    Ghoniem GM, Regnier CH, Biancani P et al (1986) Effect of vesical outlet obstruction on detrusor contractility and passive properties in rabbits. J Urol 135:1284PubMedGoogle Scholar
  8. 8.
    Landau EH, Jayanthi VR, Churchill BM et al (1994) Loss of elasticity in dysfunctional bladders: urodynamic and histochemical correlation. J Urol 152:702PubMedGoogle Scholar
  9. 9.
    Nielsen KK, Andersen CB, Petersen LK et al (1995) Morphological, stereological, and biochemical analysis of the mini-pig urinary bladder after chronic outflow obstruction and after recovery from obstruction. Neurourol Urodyn 14:269CrossRefPubMedGoogle Scholar
  10. 10.
    Tubaro A, Miano L (2002) Managing the consequence of obstruction. Eur Urol 1(Suppl):21–27CrossRefGoogle Scholar
  11. 11.
    Kojima M, Inui E, Ochiai A, Naya Y, Ukimura O, Watanabe H (1996) Ultrasonic estimation of bladder weight as a measure of bladder hypertrophy in men with infravesical obstruction: a preliminary report. Urology 47:942–947CrossRefPubMedGoogle Scholar
  12. 12.
    Manieri C, Carter SS, Romano G, Trucchi A, Valenti M, Tubaro A (1998) The diagnosis of bladder outlet obstruction in men by ultrasound measurement of bladder wall thickness. J Urol 159:761–765CrossRefPubMedGoogle Scholar
  13. 13.
    Oelke M (2010) International Consultation on Incontinence-Research Society (ICI-RS) report on non-invasive urodynamics: the need of standardization of ultrasound bladder and detrusor wall thickness measurements to quantify bladder wall hypertrophy. Neurourol Urodyn 29:634–639CrossRefPubMedGoogle Scholar
  14. 14.
    Khullar V, Salvatore S, Cardozo L et al (1994) A novel technique for measuring bladder wall thickness in women using transvaginal ultrasound. Ultrasound Obstet Gynecol 4:220CrossRefPubMedGoogle Scholar
  15. 15.
    Oelke M, Hofner K, Jonas U et al (2006) Ultrasound measurement of detrusor wall thickness in healthy adults. Neurourol Urodyn 25:308CrossRefPubMedGoogle Scholar
  16. 16.
    Naya Y, Kojima M, Honjyo H, Ochiai A, Ukimura O, Watanabe H (1998) Intraobserver and interobserver variance in the measurement of ultrasound-estimated bladder weight. Ultrasound Med Biol 24:771–773CrossRefPubMedGoogle Scholar
  17. 17.
    Kessler TM, Gerber R, Burkhard FC, Studer UE, Danuser H (2006) Ultrasound assessment of detrusor thickness in men—can it predict bladder outlet obstruction and replace pressure flow study? J Urol 175:2170–2173CrossRefPubMedGoogle Scholar
  18. 18.
    Oelke M, Höfner K, Wiese B et al (2002) Increase in detrusor wall thickness indicates bladder outlet obstruction (BOO) in men. World J Urol 19:443–452CrossRefPubMedGoogle Scholar
  19. 19.
    Oelke M, Hofner K, Jonas U et al (2007) Diagnostic accuracy of noninvasive tests to evaluate bladder outlet obstruction in men: detrusor wall thickness, uroflowmetry, postvoid residual urine, and prostate volume. Eur Urol 52:827CrossRefPubMedGoogle Scholar
  20. 20.
    Blatt AH, Titus J, Chan L (2008) Ultrasound measurement of bladder wall thickness in the assessment of voiding dysfunction. J Urol 179:2275CrossRefPubMedGoogle Scholar
  21. 21.
    Franco G, De Nunzio C, Leonardo C et al (2010) Ultrasound assessment of intravesical prostatic protrusion and detrusor wall thickness–new standards for noninvasive bladder outlet obstruction diagnosis? J Urol 183:2270–2274CrossRefPubMedGoogle Scholar
  22. 22.
    Tubaro A, Carter S, Hind A, Vicentini C, Miano L (2001) A prospective study of the safety and efficacy of suprapubic transvesical prostatectomy in patients with benign prostatic hyperplasia. J Urol 166(1):172–176CrossRefPubMedGoogle Scholar
  23. 23.
    Egilmez T, Pourbagher MA, Guvel S et al (2006) Effects of selective alpha-1-adrenergic receptor blockers on bladder weight. Urol Int 76:42–50CrossRefPubMedGoogle Scholar
  24. 24.
    Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P et al (2002) The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 21:167–178CrossRefPubMedGoogle Scholar
  25. 25.
    Khullar V, Cardozo LD, Salvatore S et al (1996) Ultra- sound: a noninvasive screening test for detrusor instability. Br J Obstet Gynaecol 103:904CrossRefPubMedGoogle Scholar
  26. 26.
    Lekskulchai O, Dietz HP (2008) Detrusor wall thick- ness as a test for detrusor overactivity in women. Ultrasound Obstet Gynecol 32:535CrossRefPubMedGoogle Scholar
  27. 27.
    Chung SD, Chiu B, Kuo HC, Chuang YC, Wang CC et al (2010) Transabdominal ultrasonography of detrusor wall thickness in women with overactive bladder. BJU Int 105:668–672CrossRefPubMedGoogle Scholar
  28. 28.
    Panayi DC, Tekkis P, Fernando R, Khullar V (2010) Is the beneficial effect of antimuscarinics related to motor or sensory changes in the bladder? Int Urogynecol J 21(7):841–845CrossRefPubMedGoogle Scholar
  29. 29.
    Robinson D, Oelke M, Khullar V, Wijkstra H, Tretter R, Stow B, Compion G, Tubaro A (2016) Bladder wall thickness in women with symptoms of overactive bladder and detrusor overactivity: Results from the randomised, placebo-controlled shrink study. Neurourol Urodyn 35(7):819–825Google Scholar
  30. 30.
    Güzel Ö, Aslan Y, Balcı M, Tuncel A, Keten T, Erkan A, Atan A (2015) Can bladder wall thickness measurement be used for detecting bladder outlet obstruction? Urology 86(3):439–444CrossRefPubMedGoogle Scholar
  31. 31.
    Oelke M, Mamoulakis C, Ubbink DT et al (2009) Manual versus automatic bladder wall thickness measurements: a method comparison study. World J Urol 27:747–753CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Tubaro A, Mariani S, De Nunzio C, Miano R (2010) Bladder weight and detrusor thickness as parameters of progression of benign prostatic hyperplasia. Curr Opin Urol 20(1):37–42CrossRefPubMedGoogle Scholar
  33. 33.
    EAU Guidelines on the Management of Male Lower Urinary Tract Symptoms (LUTS), including Benign Prostatic Obstruction (BPO) 2014.
  34. 34.
    EAU Guidelines on the Management of Urinary Incontinence 2014.

Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  • Cosimo De Nunzio
    • 1
    Email author
  • Fabrizio Presicce
    • 1
  • Andrea Tubaro
    • 1
  1. 1.Department of UrologySant’Andrea Hospital, “Sapienza” University of RomeRomeItaly

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