Changes in Bladder Wall Thickness and Detrusor Wall Thickness After Surgical Treatment of Benign Prostatic Enlargement in Patients With Lower Urinary Tract Symptoms: A Preliminary Report

Abstract

PurposeThe purpose of the present study was to evaluate the perioperative changes in bladder wall thickness and detrusor wall thickness after transurethral prostatectomy.Materials and MethodsFifty-one men who were treated for benign prostatic hyperplasia/lower urinary tract symptoms with transurethral prostatectomy were prospectively analyzed from May 2012 to July 2013. Prostate size, detrusor wall thickness, and bladder wall thickness were assessed by transrectal and transabdominal ultrasonography perioperatively. All postoperative evaluations were performed 1 month after the surgery.ResultsThe patients' mean age was 69.0 years, the mean prostate-specific antigen concentration was 8.1 ng/mL, and the mean prostate volume was 63.2 mL. The mean bladder wall thickness was 5.1 mm (standard deviation [SD], ±1.6), 5.1 mm (SD, ±1.6), and 5.0 mm (SD, ±1.4) preoperatively and 4.5 mm (SD, ±1.5), 4.5 mm (SD, ±1.3), and 4.6 mm (SD, ±1.2) postoperatively in the anterior wall, dome, and trigone, respectively (p=0.178, p=0.086, and p=0.339, respectively). The mean detrusor wall thickness was 0.9 mm (SD, ±0.4) preoperatively and 0.7 mm (SD, ±0.3) postoperatively (p=0.001). A subgroup analysis stratifying patients into a large prostate group (weight, ≥45 g) and a high Abrams-Griffiths number group (>30) showed a significant decrease in detrusor wall thickness (p=0.002, p=0.018).ConclusionsThere was a decrease in detrusor wall thickness after transurethral prostatectomy. The large prostate group and the high Abrams-Griffiths number group showed a significant decrease in detrusor wall thickness after surgery.

Establishment and value assessment of efficacy prediction model about transurethral prostatectomy

“…BWT has been shown to improve with alpha‐blocker therapy, and negatively correlate with the responsiveness of alpha‐blockers. Similar to BWT, DWT has been found to correlate with BOOI and decrease in DWT after transurethral prostatectomy …”

Change of Ultrasound Estimated Bladder Weight and Bladder Wall Thickness After Treatment of Bladder Outlet Obstruction With Dutasteride

“…Research is currently underway to determine the efficacy of UEBW and BWT as an alternative, non‐invasive approach for diagnosing BOO and evaluating bladder function . Several studies have already correlated increased wall thickness and bladder weight with BOO . The relationship between BWT and urodynamic parameters of outlet resistance was investigated by Manieri and coworkers.…”

Do functional changes occur in the bladder due to bladder outlet obstruction? ‐ ICI‐RS 2018

“…Regarding BWT and surgery, one study evaluated 51 patients with “BPH” who underwent transurethral resection of the prostate: a very small but statistically significant reduction in DWT 1 month after surgery was found. Patients with larger prostates and a high degree of obstruction showed the greatest reduction …”

“…Patients with larger prostates and a high degree of obstruction showed the greatest reduction. 41 Functional changes in the bladder due to bladder outlet obstruction may not revert to normal after treatment: Thomas et al 42 could not demonstrate any long-term symptomatic or urodynamic gains from TURP in men with both BPO and detrusor underactivity. On the other hand, decompensation was rare in this relatively small and selected group of untreated BPO patients with DU.…”