The use of ultrasound-estimated bladder weight in diagnosing bladder outlet obstruction and detrusor overactivity in men with lower urinary tract symptoms

Abstract

Objectives:Measurement of bladder weight using ultrasound estimates of bladder wall thickness and bladder volume is an emerging clinical measurement technique that may have a role in the diagnosis of lower urinary tract dysfunction. We have reviewed available literature on this technique to assess current clinical status.Methods:A systematic literature search was carried out within PubMed and MedLine to identify relevant publications. These were then screened for relevance. Preliminary results from our clinical experiments using the technique are also included.Results:We identified 17 published papers concerning the technique which covered clinical studies relating ultrasound-estimated bladder wall thickness to urodynamic diagnosis in men, women, and children together with change in response to treatment of bladder outlet obstruction. The original manual technique has been challenged by a commercially available automated technique.Conclusion:Ultrasound-estimated bladder weight is a promising non-invasive technique for the categorization of storage and voiding disorders in both men and women. Further studies are needed to validate the technique and assess accuracy of diagnosis.

Subtle errors of bladder wall thickness measurement have a significant impact on the calculation of ultrasound-estimated bladder weight. A pilot study

“…Over the past decade, the interest for bladder wall thickness (BWT) and detrusor wall thickness (DWT) measurements has grown rapidly. Their potential use as add-ons to uroflowmetry and conventional ultrasonography, has initiated a quest for their diagnostic validity in different types of lower urinary tract problems in both genders [1,2]. Even if formal standardization is still lacking, numerous studies have been published so far, using these modalities for diagnostic purposes and for the assessment of treatment efficacy.…”

“…It has been proved that a urodynamic diagnosis of detrusor overactivity (DO) correlates well with BWT and DWT measurements [3][4][5][6]. A small study could not distinguish between DO and bladder outlet obstruction (BOO) in males [1]. A recent meta-analysis on non invasive diagnostic tests in males with lower urinary tract symptoms (LUTS), did not find any threshold or cut-off value that can be safely used [7].…”

“…The bladder wall appears on ultrasound (US) as a three-layered structure with the hypoechoic detrusor between the two hyperechoic layers that represent the mucosa and the serosa [1]. Various techniques have been proposed to measure BWT and DWT, using different approaches (transvaginal, transperineal or suprapubic), with different probes (3.5 MHz, 5 MHz, or 7.5 MHz) in either an empty bladder or in comfortable filling volumes [11].…”

“…Ultrasound-estimated bladder weight (UEBW) concept has been advocated as a more reliable measure of bladder wall hypertrophy, because it can be calculated regardless of the degree of bladder filling. UEBW has been used as a diagnostic tool in males or females with LUTS, as a predictor of the outcome or as a monitoring tool [1].…”

Ultrasound estimated bladder weight in the detection and post-operative follow-up of bladder outflow obstruction

“…The detrusor muscle layer shows by a hypoechogenic layer between two hyperechogenic layers the serosa and mucosa respectively. 5, 6 The measurement of different layers of urinary bladder varies investigator to investigator. Some measured the whole thickness of three layers together but others use the measurement of middle detrusor muscle only.…”