Fabrizio Presicce1, Cosimo DE Nunzio2,3, Mauro Gacci3,4, Enrico Finazzi Agrò3,5, Andrea Tubaro2. 1. Department of Urology, Ospedale Sant'Andrea, "Sapienza" University of Rome, Rome, Italy - fabriziopresicce@libero.it. 2. Department of Urology, Ospedale Sant'Andrea, "Sapienza" University of Rome, Rome, Italy. 3. Research Committee of The Italian Society of Urodynamics, Bologna, Italy. 4. Department of Urology, Ospedale Careggi, University of Florence, Florence, Italy. 5. Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Unit of Functional Urology, Tor Vergata University Hospital, Rome, Italy.
Abstract
BACKGROUND: To evaluate the role of the ultrasound assessments of the bladder/detrusor wall thickness (BWT/DWT) and the ultrasound estimated bladder weight (UEBW) in lower urinary tract symptoms diagnosis and treatment. EVIDENCE ACQUISITION: A systematic literature search from January 1995 until February 2016 was performed on PubMed using the following terms: "bladder weight", "bladder wall thickness", "detrusor wall thickness", "LUTS", "bladder outlet obstruction" (BOO), "benign prostatic obstruction". Additional references were obtained from the reference list of full-text manuscripts. Abstracts presented at the annual congresses of the European Association of Urology, American Urology Association and the International Continence Society were also included. EVIDENCE SYNTHESIS: BWT and DWT are accurate predictors of BOO. Despite several differences in the technique assessment, population characteristics and study design, the BWT/DWT accuracy for BOO was close to 90%. Furthermore, the ultrasound evaluation of bladder/detrusor thickness correlates positively with symptoms score and the main clinical parameters in BPH patients. Lastly, BWT and DWT have proved to be optimal predictor of response to medical/surgical treatment of lower urinary tract symptoms/benign prostatic obstruction (LUTS/BPO). However, the lack of standardization among the available studies marks these methods promising but still experimental and further studies are needed to clarify the standard methodology. CONCLUSIONS: The ultrasound evaluation of bladder/detrusor thickness appears to be simple, highly accurate and non-invasive technique to predict BOO and to evaluate the clinical outcomes after medical/surgical treatments for LUTS/BPH. The implementation of these techniques and their standardization will probably better define their role in the diagnostic algorithms of patients with LUTS and possibly reduce the number of unnecessary pressure flow-studies.
BACKGROUND: To evaluate the role of the ultrasound assessments of the bladder/detrusor wall thickness (BWT/DWT) and the ultrasound estimated bladder weight (UEBW) in lower urinary tract symptoms diagnosis and treatment. EVIDENCE ACQUISITION: A systematic literature search from January 1995 until February 2016 was performed on PubMed using the following terms: "bladder weight", "bladder wall thickness", "detrusor wall thickness", "LUTS", "bladder outlet obstruction" (BOO), "benign prostatic obstruction". Additional references were obtained from the reference list of full-text manuscripts. Abstracts presented at the annual congresses of the European Association of Urology, American Urology Association and the International Continence Society were also included. EVIDENCE SYNTHESIS: BWT and DWT are accurate predictors of BOO. Despite several differences in the technique assessment, population characteristics and study design, the BWT/DWT accuracy for BOO was close to 90%. Furthermore, the ultrasound evaluation of bladder/detrusor thickness correlates positively with symptoms score and the main clinical parameters in BPH patients. Lastly, BWT and DWT have proved to be optimal predictor of response to medical/surgical treatment of lower urinary tract symptoms/benign prostatic obstruction (LUTS/BPO). However, the lack of standardization among the available studies marks these methods promising but still experimental and further studies are needed to clarify the standard methodology. CONCLUSIONS: The ultrasound evaluation of bladder/detrusor thickness appears to be simple, highly accurate and non-invasive technique to predict BOO and to evaluate the clinical outcomes after medical/surgical treatments for LUTS/BPH. The implementation of these techniques and their standardization will probably better define their role in the diagnostic algorithms of patients with LUTS and possibly reduce the number of unnecessary pressure flow-studies.
Authors: Sung Yong Cho; Kyungtae Ko; Kyo Chul Koo; Hyung Joon Kim; Woo Jin Bang; Min Soo Choo; Sang Hyub Lee; Young Eun Yoon; Wonho Jung; Jae Young Choi; Dong Sup Lee Journal: Biomed Res Int Date: 2020-08-10 Impact factor: 3.411