Presurgical bladder wall thickness is a useful marker to predict the postsurgical improvement of symptoms in patients with pelvic organ prolapse‐related overactive bladder

Abstract

Objectives: Pelvic organ prolapse (POP) is a cause of overactive bladder (OAB), and transvaginal mesh (TVM) surgery can improve the symptoms. Bladder wall thickness (BWT) is a useful and safe marker to evaluate bladder function in urinary disorders. The main purpose of this study is to clarify the relationship between BWT and changes in the OAB symptom score (OABSS) after TVM operation in patients with POP.Methods: BWT was measured by ultrasonography before and 6 months after surgery at three sites in the bladder: the anterior wall, trigone, and dome. Similarly, the OABSS was evaluated at the time of BWT measurement. Changes induced in BWT at each site and the mean BWT at all sites after TVM surgery were analyzed. Similarly, the relationship between presurgical BWT and the decrease in OABSS was investigated.Results: TVM surgery improved OABSS in 30 patients (responders; 73.2%), while 11 patients were judged as nonresponders (26.8%). BWT at the anterior bladder wall and dome as well as the mean BWT at all three sites were significantly decreased by TVM surgery (P < .001). Similar trends were identified in OABSS responders; however, all markers showed no significant changes in OABSS nonresponders. All the BWT-related markers before surgery were significantly lower in OABSS responders than in OABSS nonresponders.Conclusions: BWT at the bladder anterior wall and dome, but not the trigone, were decreased by TVM surgery. We conclude that presurgical BWT may be a useful marker to predict the improvement in OAB symptoms by TVM surgery in patients with POP-related OAB.

Efficacy and safety profile of olaparib for patients with metastatic castration‐resistant prostate cancer: A preliminary report of real‐world data in a single institution in Japan

“…In response to the Editorial Comment 1 on our recently published article, 2 we broadly agree with the editor about the importance and promising potential of transvaginal bladder ultrasound (TBU) in the study of certain urologic conditions, such as neurogenic bladder and voiding dysfunctions 3 and, as we report, in the diagnosis of chronic trigonitis in women with recurrent urinary tract infections. 2 In addition to being more comfortable and much less invasive than cystoscopy, TBU can be performed quickly and safely, using a relatively low-cost technology that is already widely accessible, even in Third World countries.…”

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Recently, a variety of agents, including abiraterone, cabazitaxel, and enzalutamide, have been approved in Japan for patients with metastatic castration-resistant prostate cancer (CRPC). [1][2][3] Some patients, however, have already received all these agents and need a different systemic therapy. The novel agent olaparib (Lynparza, AstraZeneca) is a poly ADP-ribose polymerase inhibitor that was recently approved for the treatment of metastatic CRPC in patients harboring BRCA1/2 mutations.

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The Surgical Management of Large Bladder Calculi and Irreducible Uterine Prolapse: A Case Report and Review of Literature

“…Similarly, patients with prevalent pelvic organ prolapse exhibit symptoms of the lower urinary tracts, such as an overactive bladder, which may lead to an increase in the thickness of the bladder wall. The bladder's inflammatory response thickened the bladder wall, making the prolapsed vagina irreducible [5]. Bladder calculi should be suspected in firm nodular anterior prolapse that is difficult to reduce.…”

Editorial Comments on Transvaginal ultrasonography for trigonitis diagnosis in women

“…In female patients with an overactive bladder (OAB) associated with pelvic organ prolapse, we demonstrated that bladder wall thickness, before transvaginal mesh surgery influenced residual postoperative OAB symptoms. 1 In our study, the bladder urine volume was set to <50 mL before transvaginal bladder ultrasound (TBU) examination based on a previous study. 2 The bladder capacity setting at the time of examination is essential because an overextended bladder can lead to an underestimation of the bladder wall thickness.…”