Ultrasound measurement of vaginal wall thickness: a novel and reliable technique

Panayi, Demetri; Digesu, G. Alessandro; Tekkis, Paris; Fernando, Ruwan; Khullar, Vikram

doi:10.1007/s00192-010-1183-4

Cited by 46 publications

(53 citation statements)

References 21 publications

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“…49,51,54,57,72,117 Our study is the most conclusively negative study of the diagnostic value of bladder ultrasonography to date.…”

Section: Diagnostic Accuracy Of Bwt Via Bladder Ultrasonography In Thmentioning

confidence: 67%

“…In an update of the systematic review on the diagnostic accuracy of BWT in diagnosing DO (unpublished data: Suneetha Rachaneni, University of Birmingham, 2015) 21 studies 28,[49][50][51][52][53][54][55][56][57][58][59]72,97,[113][114][115][116][117][118][119] have been identified that have investigated the relationship between BWT measured by ultrasonography and DO, results from which for the sensitivity, specificity and AUC for bladder ultrasonography vary from 37% to 91%, 61% to 97% and 0.61-0.91, respectively (see Appendix 7). The studies draw mixed conclusions, ranging from…”

Section: Placing the Results In The Context Of Other Researchmentioning

confidence: 99%

“…Six previous studies on reliability and reproducibility of BWT have used a variety of ultrasonography techniques, including transabdominal 56 and translabial 51 as well as transvaginal 44,56,72,129 (as summarised in Appendix 8). Several of these studies investigated women with different or a mixture of aetiologies, or used levels of bladder filling.…”

Section: Findings In the Context Of Existing Datamentioning

confidence: 99%

“…Several of these studies investigated women with different or a mixture of aetiologies, or used levels of bladder filling. Of the transvaginal ultrasonography studies, only two 56,72 included assessment of repeated scans as in our third substudy, evaluating 10 and 25 women, respectively. The other two studies 44,129 only evaluated the reproducibility of image interpretation (as in our first and second substudy) based on repeated assessment of 10 and 1544 images, respectively.…”

Section: Findings In the Context Of Existing Datamentioning

confidence: 99%

“…Reporting of the study design and statistical analysis was often incomplete or ambiguous. Khullar et al, 44 Panayi et al 72 and Tubaro et al 129 all reported Bland-Altman analyses from which pseudo estimates of measurement error have been computed (see Appendix 8). …”

Section: Findings In the Context Of Existing Datamentioning

confidence: 99%

See 4 more Smart Citations

Bladder ultrasonography for diagnosing detrusor overactivity: test accuracy study and economic evaluation

Rachaneni

McCooty

Middleton

et al. 2016

Health Technol Assess

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BackgroundUrodynamics (UDS) has been considered the gold standard test for detrusor overactivity (DO) in women with an overactive bladder (OAB). Bladder ultrasonography to measure bladder wall thickness (BWT) is less invasive and has been proposed as an alternative test.ObjectivesTo estimate the reliability, reproducibility, accuracy and acceptability of BWT in women with OAB, measured by ultrasonography, in the diagnosis of DO; to explore the role of UDS and its impact on treatment outcomes; and to conduct an economic evaluation of alternative care pathways.DesignA cross-sectional test accuracy study.Setting22 UK hospitals.Participants687 women with OAB.MethodsBWT was measured using transvaginal ultrasonography, and DO was assessed using UDS, which was performed blind to ultrasonographic findings. Intraobserver and interobserver reproducibility were assessed by repeated measurements from scans in 37 and 57 women, respectively, and by repeated scans in 27 women. Sensitivity and specificity were computed at pre-specified thresholds. The smallest real differences detectable of BWT were estimated using one-way analysis of variance. The pain and acceptability of both tests were evaluated by a questionnaire. Patient symptoms were measured before testing and after 6 and 12 months using the International Consultation on Incontinence modular Questionnaire Overactive Bladder (short form) (ICIQ-OAB) questionnaire and a global impression of improvement elicited at 12 months. Interventions and patient outcomes were analysed according to urodynamic diagnoses and BWT measurements. A decision-analytic model compared the cost-effectiveness of care strategies using UDS, ultrasonography or clinical history, estimating the cost per woman successfully treated and the cost per quality-adjusted life-year (QALY).ResultsBWT showed very low sensitivity and specificity at all pre-specified cut-off points, and there was no evidence of discrimination at any threshold (p = 0.25). Extensive sensitivity and subgroup analyses did not alter the interpretation of these findings. The smallest detectable difference in BWT was estimated to be 2 mm. Pain levels following both tests appeared relatively low. The proportion of women who found the test ‘totally acceptable’ was significantly higher with ultrasonography than UDS (81% vs. 56%;p < 0.001). Overall, subsequent treatment was highly associated with urodynamic diagnosis (p < 0.0001). There was no evidence that BWT had any relationship with the global impression of improvement responses at 20 months (p = 0.4). Bladder ultrasonography was more costly and less effective than the other strategies. The incremental cost-effectiveness ratio (ICER) of basing treatment on the primary clinical presentation compared with UDS was £491,500 per woman successfully treated and £60,200 per QALY. Performing a UDS in those women with a clinical history of mixed urinary incontinence had an ICER of £19,500 per woman successfully treated and £12,700 per QALY compared with the provision of urodynamic to all women. For DO cases detected, UDS was the most cost-effective strategy.ConclusionThere was no evidence that BWT had any relationship with DO, regardless of the cut-off point, nor any relationship to symptoms as measured by the ICIQ-OAB. Bladder ultrasonography has no diagnostic or prognostic value as a test in this condition. Furthermore, despite its greater acceptability, BWT measurement was not sufficiently reliable or reproducible.Trial registrationCurrent Controlled Trials ISRCTN46820623.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 20, No. 7. See the NIHR Journals Library website for further project information.

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“…49,51,54,57,72,117 Our study is the most conclusively negative study of the diagnostic value of bladder ultrasonography to date.…”

Section: Diagnostic Accuracy Of Bwt Via Bladder Ultrasonography In Thmentioning

confidence: 67%

Section: Placing the Results In The Context Of Other Researchmentioning

confidence: 99%

Section: Findings In the Context Of Existing Datamentioning

confidence: 99%

Section: Findings In the Context Of Existing Datamentioning

confidence: 99%

Section: Findings In the Context Of Existing Datamentioning

confidence: 99%

See 3 more Smart Citations

Bladder ultrasonography for diagnosing detrusor overactivity: test accuracy study and economic evaluation

Rachaneni

McCooty

Middleton

et al. 2016

Health Technol Assess

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Transabdominal sonography to measure the total vaginal and mucosal thicknesses

Balica

Schertz

Wald-Spielman

et al. 2017

J of Clinical Ultrasound

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Transabdominal and transvaginal sonography are used to measure bladder wall and detrusor thickness. Only transvaginal sonography has been used to measure the vaginal wall thickness. We describe the use of transabdominal sonography to measure the total vaginal wall thickness and total vaginal mucosal thickness at the bladder trigone. The mean bladder wall thickness and SD from published data were within the 95% confidence interval of our data. Total vaginal and mucosal thicknesses are reliable measurements, which require specific evaluation in a postmenopausal population. They could be used to quantify vaginal atrophy and could correlate to symptoms of atrophy and response to treatment. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:461-464, 2017.

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Vaginal wall thickness as potential biomarker of vaginal health. A proposal for standardized ultrasound measurement using three‐dimensional transvaginal ultrasound

Alcazar,

Para,

Tomaizhe

et al. 2023

J of Clinical Ultrasound

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Vaginal wall thickness could be used as a biomarker of vaginal health. We propose a standardized method using three‐dimensional (3D) ultrasound for measuring vaginal wall thickness. Fill the vagina with gel. Insert the endovaginal transducer into the vagina up to the middle third. In the sagittal plane, visualizing the cervix and vaginal fornices, capture a 3D volume of the upper third of the vagina. Using tomographic ultrasound imaging function in the sagittal plane and the posterior vaginal fornix as the reference obtain at least three axial planes of the vagina, separated by 1 cm. Measure the vaginal wall thickness at a distance of 2 cm from the posterior vaginal fornix at 12, 3, 6, and 9 o'clock. The reproducibility of measurements was high. Measurements of vaginal wall thickness can be reliably performed.

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Ultrasound measurement of vaginal wall thickness: a novel and reliable technique

Abstract: Ultrasound vaginal wall thickness demonstrated good intra- and interoperator reliability, as well as consistency with histological measurement. It is a valid technique.

Cited by 46 publications

References 21 publications

Bladder ultrasonography for diagnosing detrusor overactivity: test accuracy study and economic evaluation

Bladder ultrasonography for diagnosing detrusor overactivity: test accuracy study and economic evaluation

Transabdominal sonography to measure the total vaginal and mucosal thicknesses

Vaginal wall thickness as potential biomarker of vaginal health. A proposal for standardized ultrasound measurement using three‐dimensional transvaginal ultrasound

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