Re: Ultrasound bladder wall thickness and detrusor overactivity: a multicentre test accuracy study

Authors’ reply re: Ultrasound bladder wall thickness and detrusor overactivity: a multicentre test accuracy study

“…We address the comments by Asfour et al. on our evaluation of ultrasound bladder wall thickness (BWT) to diagnose detrusor overactivity (DO) – the BUS study …”

“…Second, the accuracy figures for urodynamics quoted are for the accuracy of symptoms and signs for diagnosis of DO compared with a urodynamic reference diagnosis, and not the accuracy of urodynamics per se as Asfour et al. claim.…”

“…Furthermore, the measurement error of BWT in standard practice was high . Others have questioned the value of BWT – a randomised controlled trial concluded that routine clinical assessment of BWT for monitoring the effects of OAB/DO treatment is not clinically useful; there is no difference in outcome to anticholinergic therapy regardless of urodynamic findings; and urodynamic diagnosis of DO does not alter patient‐reported outcomes for invasive treatments such as botulinum toxin A and sacral neural stimulation . The value of performing urodynamics before invasive treatments in overactive bladder compared with treatment directed by clinical assessment is to be evaluated in a randomised controlled trial (the FUTURE study) that is soon to commence.…”