Can Bladder Wall Thickness Measurement Be Used for Detecting Bladder Outlet Obstruction?

To investigate the relationship between bladder wall thickness (BWT) and uroflowmetric parameters and the International Prostate Symptoms Score (IPSS) in patients with lower urinary tract symptoms (LUTS).

A total of 236 male patients who had LUTS-related benign prostatic enlargement with serum prostate-specific antigen level ≤4 ng/mL were included in this study. Age and duration of LUTS and IPSS were recorded. BWT was measured using 7.5 mHz suprapubic ultrasonography before uroflowmetry and postvoid residual (PVR) was calculated thereafter. The relationship between BWT and poor indicators for bladder outlet obstruction (BOO) (IPSS >19, Qmax <15 mL/min, PVR >100 cm(3)) was investigated.

The mean age was 62.5 ± 8.1 (39-77) years and the mean BWT was 3.8 ± 1.5 (1.4-8.7) mm. The mean IPSS, Qmax, PVR, and duration of LUTS were 17.7, 13.7 mL/min, 89.9, and 46.5 months, respectively. A positive correlation was found between BWT and IPSS, PVR and duration of LUTS, whereas a negative correlation was found between BWT and Qmax (P <.001). BWT increased when number of BOO parameters increased. BWT was 2.9 in patients without BOO parameters whereas BWT was 3.5, 4.1, and 4.5 mm in patients with any one, any two, and all parameters of BOO, respectively.

BWT increased when number of BOO parameters increased. We believe that measurement of BWT is an easy, quick, and repeatable test to predict BOO severity.