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Review on ultrasound measurement of bladder or detrusor wall thickness in women: techniques, diagnostic utility, and use in clinical trials

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Abstract

Purpose

To provide a narrative review of literature evaluating ultrasound techniques for the measurement of bladder wall hypertrophy in women as an alternative to invasive urodynamic assessment for the diagnosis of lower urinary tract symptoms (LUTS).

Methods

A literature review was performed using PubMed and all paper journals of congress abstracts searching for articles on ultrasound measurement of bladder wall thickness (BWT) or detrusor wall thickness (DWT) published between January 1990 and May 2012. Each study was classified with a level of evidence using the Oxford Centre for Evidence-based Medicine classification (2009).

Results

Ultrasound measurement of bladder wall hypertrophy is not standardised, and techniques vary widely according to anatomical approach, ultrasound frequency and other factors. This review compared transvaginal, translabial/transperineal and suprapubic approaches for ultrasound BWT/DWT measurement. BWT/DWT measurements correlated well with urodynamic diagnoses of detrusor overactivity (DO) using all three ultrasound techniques. BWT values were consistently higher in women with DO than in women with stress incontinence, although threshold values for the differential diagnosis of DO varied between clinical studies (5.0–6.5 mm using transvaginal ultrasound). Few data were available on the use of translabial or suprapubic ultrasound in women. Inter- and intraobserver variability was higher with transperineal and suprapubic ultrasound, and these techniques appear less reliable than transvaginal ultrasound. Studies suggest that BWT is reduced in response to antimuscarinic therapy in women with overactive bladder or DO.

Conclusions

Data from clinical trials suggest that transvaginal ultrasound measurement of BWT is a reliable method of diagnosing DO in women with LUTS, and BWT decreases during antimuscarinic therapy.

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Abbreviations

BOO:

Bladder outlet obstruction

BWT:

Bladder wall thickness

DO:

Detrusor overactivity

DWT:

Detrusor wall thickness

LUTS:

Lower urinary tract symptoms

MHz:

Mega Hertz

MUI:

Mixed urinary incontinence

OAB:

Overactive bladder

SD:

Standard deviation

SUI:

Stress urinary incontinence

95 % CI:

95 % confidence interval

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Acknowledgments

The research for this review was undertaken with a grant from Astellas Pharma Europe Ltd. All authors had full access to all the data in the study and the primary author (MO) had final responsibility for the decision to submit this manuscript for publication. Writing and editorial assistance was provided by Matthew Cunningham and Lindsay Napier of Darwin Healthcare Communications, and was funded by Astellas.

Conflict of interest

Matthias Oelke has received Lecturer and/or Consultant Honoraria from Apogepha, Astellas and Pfizer, and received a research grant from Astellas. Vik Khullar is a Consultant and Speaker for Astellas, Pfizer and Allergan. Hessel Wijkstra has received Consultant Honoraria from Astellas.

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Authors and Affiliations

  1. Department of Urology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany

    Matthias Oelke

  2. St. Mary’s Hospital, Imperial College, London, UK

    Vik Khullar

  3. AMC University Hospital Amsterdam, Eindhoven University of Technology, Eindhoven, The Netherlands

    Hessel Wijkstra

Authors
  1. Matthias Oelke
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  2. Vik Khullar
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  3. Hessel Wijkstra
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Corresponding author

Correspondence to Matthias Oelke.

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Oelke, M., Khullar, V. & Wijkstra, H. Review on ultrasound measurement of bladder or detrusor wall thickness in women: techniques, diagnostic utility, and use in clinical trials. World J Urol 31, 1093–1104 (2013). https://doi.org/10.1007/s00345-013-1030-6

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  • DOI: https://doi.org/10.1007/s00345-013-1030-6

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