Bladder wall thickness in women with symptoms of overactive bladder and detrusor overactivity: Results from the randomised, placebo-controlled shrink study

Abstract

There was no consistent effect of solifenacin on BWT in women with OAB/DO, despite improvements in efficacy endpoints. This study suggests that routine clinical assessment of BWT with TVUS for monitoring the effects of OAB/DO treatment is not clinically useful. Neurourol. Urodynam. 35:819-825, 2016. © 2015 Wiley Periodicals, Inc.

Tolterodine ER reduced increased bladder wall thickness in women with overactive bladder. A randomized, placebo‐controlled, double‐blind, parallel group study

“…The results of this study are in conflict with those of the recent RCT of Solifenacin . However, in that study, a urodynamic finding of DO was required for inclusion, while an increased BWT was not necessary.…”

“…Changes are most pronounced for patients with increased BWT (≥5 mm), with reductions from a baseline of less than 5 mm being unlikely . For example, in a recent large RCT of women with DO, with mean baseline BWT of around 5 mm, no differences were observed following anticholinergic treatment …”

Detrusor overactivity increases bladder wall thickness in male patients: A urodynamic multicenter cohort study

“…However, in the SHRINK study only 50% of women had a baseline BWT value above 5.0 mm, which is considered the preferred BWT threshold value to define the presence of DO compared to healthy subjects . Consistently in a subgroup analysis of the SHRINK study, patients with a baseline BWT >5 mm showed numerically greater reductions in BWT values . These data are also supported by a multicenter randomized placebo controlled double blind trial to evaluate whether tolterodine can reverse the increased BWT in female patients with OAB.…”

“…However, conflicting results were observed in some prospective studies evaluating BWT to diagnose DO or as a proxy of antimuscarinic treatment. In the SHRINK trial, Robinson et al exclusively evaluated the possible role of BWT as a proxy of solifenacin efficacy in female patients with OAB . The study was not designed to evaluate the diagnostic accuracy of BWT versus DO considering that no control group (patients without a diagnosis of DO) was included in the trial and no post‐treatment urodynamic examination was performed to test the persistence of DO .…”

“…In the SHRINK trial, Robinson et al exclusively evaluated the possible role of BWT as a proxy of solifenacin efficacy in female patients with OAB . The study was not designed to evaluate the diagnostic accuracy of BWT versus DO considering that no control group (patients without a diagnosis of DO) was included in the trial and no post‐treatment urodynamic examination was performed to test the persistence of DO . They concluded that BWT cannot be used to monitor antimuscarinic treatment in female patients with OAB .…”