Ultrasound measurement of detrusor wall thickness in healthy adults

Oelke, Matthias; Höfner, K.; Jonas, Udo; Ubbink, Dirk T.; Rosette, Jean de la; Wijkstra, Hessel

doi:10.1002/nau.20242

Cited by 119 publications

(111 citation statements)

References 30 publications

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“…Currently, DWT measurement techniques have started to become standardized through numerous studies (4,5,7,9,10,19). It was previously demonstrated that DWT depends only on gender, bladder filling, and LUTS severity (7,18), and DWT was not affected by patient age (19). As all of our patients were male, the only variables that might affect DWT measurements were bladder volume and IPSS.…”

Section: Discussionmentioning

confidence: 83%

“…Some authors proposed to measure DWT only to receive more detailed information about the detrusor muscle and the status of muscle decompensation (7,18). In ultrasonographic images, the mucosa and adventitia appear hyperechogenic (Fig.…”

Section: Discussionmentioning

confidence: 99%

“…In ultrasonographic images, the mucosa and adventitia appear hyperechogenic (Fig. 1), but the adventitia may not always be discriminated from the perivesical tissue, which is also hyperechogenic (18). Consequently, marker placement in perivesical tissue instead of adventitia would cause a false increase in bladder wall thickness (BWT).…”

Section: Discussionmentioning

confidence: 99%

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Diagnostic values of detrusor wall thickness, postvoid residual urine and prostate volume to evaluate lower urinary tract symptoms in men

Tokgöz

Tokgöz²,

Ünal³

et al. 2011

Diagn Interv Radiol

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Lower urinary tract symptoms (LUTS) are common, affecting approximately 40% of older men (1). LUTS is a recent term for what used to be known as prostatism (2). However, obstructive disorders of the lower urinary tract may also be caused by other diseases, such as bladder neck contractures, urethral valves, or external sphincter dyssynergia. However, for the majority of cases in the male population, the etiology is benign prostatic hyperplasia (BPH).Various animal and human studies have revealed that a significant enlargement of the bladder wall is attributable to smooth muscle cell hypertrophy, fibrocyte hyperplasia, and collagen deposition in the detrusor (3, 4). From a clinical perspective, thickening of the bladder wall should be considered as a sign of significant subvesical obstruction (5). The best way to visualize this detrusor muscle hypertrophy in a noninvasive manner is to measure the detrusor wall thickness (DWT) by suprapubic ultrasonography. In 2006, Belal and Abrams (6) evaluated noninvasive methods used to diagnose bladder outlet obstruction (BOO) in a meta-analysis and observed that ultrasound measurements of the DWT and bladder weight were the only predictors of subvesical obstruction in LUTS patients.It is widely accepted that DWT decreases continuously while the bladder fills to 50% of its capacity and then remains constant until 100%. Therefore, the detrusor wall measurements are performed on patients when the bladder is filled to maximum capacity only (7). However, no study has been published that evaluates the diagnostic accuracy of DWT when the bladder is empty. In our study, we investigated the association between the LUTS severity and DWT. In addition, the parameter "DWT when the bladder was empty" was also evaluated as a noninvasive diagnostic tool to predict LUTS in men.An ideal assessment tool to detect LUTS must be noninvasive, quick, inexpensive, and reproducible with high diagnostic accuracy. Ultrasonography has all of these criteria with additional advantages (no contrast material and no ionizing radiation). In uro-radiology practice, conventional ultrasound-derived noninvasive tests for the evaluation of LUTS severity can achieve measurements of DWT, postvoid residual urine volume (PVR), and prostate and bladder volumes. Hence, our primary aim in this prospective, controlled clinical study was to analyze the diagnostic accuracy of these ultrasound-derived noninvasive tools (i.e., DWT when the bladder is full and empty, PVR, and bladder and prostate volumes) in healthy, mildly symptomatic, and moderately-toseverely symptomatic men, and compare the outcomes in each group. In addition, their correlation according to International Prostate Symptom Score (IPSS) and age groups as well as differences in DWT values were also investigated. Our hypothesis was that these tests would accurately discriminate symptomatic cases from healthy subjects and would ABDOMINAL IMAGING MATERIALS AND METHODSDuring an 18-month period, a total of 243 males were included in the study. Three groups were a...

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

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Diagnostic values of detrusor wall thickness, postvoid residual urine and prostate volume to evaluate lower urinary tract symptoms in men

Tokgöz

Tokgöz²,

Ünal³

et al. 2011

Diagn Interv Radiol

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“…needle length and detrusor thickness, are most crucial in regard to injection depth. One can now assume that the surgeon could choose the needle length according to the detrusor thickness, which can be measured using ultrasound at a defined filling level [12]. This measurement however might not be very reliable during cystoscopic BoNT/A injection, as filling volumes and therefore detrusor thickness is likely to change during cystoscopy due to diuresis and more likely due to the regular use of flushing and draining of saline.…”

Section: Discussionmentioning

confidence: 99%

“…Target structure of the toxin is the detrusor muscle, as its main mechanism of action is at the neuromuscular junction [10,11]. However, detrusor thickness is variable and depends on several factors such as gender, age, bladder filling volume and the presence of neurogenic lesion or obstruction [12,13]. Although injection is performed under cystoscopic guidance, injection depth can only be estimated by the surgeon.…”

Section: Introductionmentioning

confidence: 99%

A morphological evaluation of botulinum neurotoxin A injections into the detrusor muscle using magnetic resonance imaging

et al. 2009

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OBJECTIVES: Although botulinum neurotoxin type A (BoNT/A) intradetrusor injections are a recommended therapy for neurogenic detrusor overactivity (NDO), refractory to antimuscarinic drugs, a standardisation of injection technique is missing. Furthermore, some basic questions are still unanswered, as where the toxin solution exactly spreads after injection. Therefore, we investigated the distribution of the toxin solution after injection into the bladder wall, using magnet resonance imaging (MRI). METHODS: Six patients with NDO were recruited. Three of six patients received 300 U of BoNT/A + contrast agent distributed over 30 injection sites (group 1). The other three patients received 300 U of BoNT/A + contrast agent distributed over 10 injection sites (group 2). Immediately after injection, MRI of the pelvis was performed. The volume of the detrusor and the total volume of contrast medium inside and outside the bladder wall were calculated. RESULTS: In all patients, a small volume (mean 17.6%) was found at the lateral aspects of the bladder dome in the extraperitoneal fat tissue, whereas 82.4% of the injected volume reached the target area (detrusor). In both groups there was a similar distribution of the contrast medium in the target area. A mean of 33.3 and 25.3% of the total detrusor volume was covered in group 1 and 2, respectively. Six weeks after injection, five of six patients were continent and showed no detrusor overactivity in the urodynamic follow-up. No systemic side effects were observed. CONCLUSIONS: Our results provide morphological arguments that the currently used injection techniques are appropriate and safe.A morphological evaluation of botulinum neurotoxin A injections into the detrusor muscle using magnetic resonance Abstract ObjectivesAlthough botulinum neurotoxin type A (BoNT/A) intradetrusor injections are a recommended therapy for neurogenic detrusor overactivity (NDO), refractory to antimuscaric drugs, a standardisation of injection technique is missing. Furthermore, some basic questions are still unanswered, as where the toxin solution exactly spreads after injection. Therefore, we investigated the distribution of the toxin solution after injection into the bladder wall, using magnet resonance imaging (MRI). MethodsSix patients with NDO were recruited. 3 of 6 patients received 300 units of BoNT/A + contrast agent distributed over 30 injection sites (Group 1). The other 3 patients received 300 units of BoNT-A + contrast agent distributed over 10 injection sites (Group 2).Immediately after injection, MRI of the pelvis was performed. The volume of the detrusor and the total volume of contrast medium inside and outside the bladder wall were calculated. ResultsIn all patients, a small volume (mean 17.6%) was found at the lateral aspects of the bladder dome in the extraperitoneal fat tissue, whereas 82.4% of the injected volume reached the target area (detrusor).In both groups there was a similar distribution of the contrast medium in the target area.A mean of 33.3% and 25.3% of th...

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A Dynamic Ultrasound Phantom with Tissue‐Mimicking Mechanical and Acoustic Properties

Fernandez,

Kim,

Sadat

et al. 2024

Advanced Science

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Tissue‐mimicking phantoms are valuable tools that aid in improving the equipment and training available to medical professionals. However, current phantoms possess limited utility due to their inability to precisely simulate multiple physical properties simultaneously, which is crucial for achieving a system understanding of dynamic human tissues. In this work, novel materials design and fabrication processes to produce various tissue‐mimicking materials (TMMs) for skin, adipose, muscle, and soft tissue at a human scale are developed. Target properties (Young's modulus, density, speed of sound, and acoustic attenuation) are first defined for each TMM based on literature. Each TMM recipe is developed, associated mechanical and acoustic properties are characterized, and the TMMs are confirmed to have comparable mechanical and acoustic properties with the corresponding human tissues. Furthermore, a novel sacrificial core to fabricate a hollow, ellipsoid‐shaped bladder phantom complete with inlet and outlet tubes, which allow liquids to flow through and expand this phantom, is adopted. This dynamic bladder phantom with realistic mechanical and acoustic properties to human tissues in combination with the developed skin, soft tissue, and subcutaneous adipose tissue TMMs, culminates in a human scale torso tank and electro‐mechanical system that can be systematically utilized for characterizing various medical imaging devices.

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Ultrasound measurement of detrusor wall thickness in healthy adults

Abstract: DWT remains stable at a bladder filling of 250 ml. At this state of bladder filling, DWT between different groups are comparable. Men have to be evaluated separately from women.

Cited by 119 publications

References 30 publications

Diagnostic values of detrusor wall thickness, postvoid residual urine and prostate volume to evaluate lower urinary tract symptoms in men

Diagnostic values of detrusor wall thickness, postvoid residual urine and prostate volume to evaluate lower urinary tract symptoms in men

A morphological evaluation of botulinum neurotoxin A injections into the detrusor muscle using magnetic resonance imaging

A Dynamic Ultrasound Phantom with Tissue‐Mimicking Mechanical and Acoustic Properties

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