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Ultrasound bladder wall thickness and detrusor overactivity: a multicentre test accuracy study
P Latthe1,2, L Middleton3, S Rachaneni1
1Institute of Metabolism and Systems Biology, University of Birmingham, Edgbaston, Birmingham, UK.
BJOG : an International Journal of Obstetrics and Gynaecology
|February 9, 2017
Summary
Bladder wall thickness (BWT) ultrasound is not a reliable replacement for urodynamics in diagnosing detrusor overactivity (DO) in women with overactive bladder (OAB). This study found BWT lacks sufficient accuracy for clinical use in this patient group.
Area of Science:
- Urology
- Diagnostic Imaging
- Gynecology
Background:
- Overactive bladder (OAB) affects many women, often necessitating invasive urodynamic testing before treatment.
- Bladder wall thickness (BWT) ultrasound offers a less invasive, cost-effective alternative for diagnosing detrusor overactivity (DO).
Purpose of the Study:
- To assess the diagnostic accuracy of BWT ultrasound in identifying DO in women with OAB symptoms.
- To determine if BWT can serve as a suitable replacement for traditional urodynamic testing.
Main Methods:
- A prospective cohort study involving 644 women with OAB symptoms across 22 UK clinics.
- Transvaginal ultrasound was used to measure BWT (index test).
- Multichannel subtracted cystometry (urodynamics) served as the reference standard for DO diagnosis.
Main Results:
- The study found BWT had a sensitivity of 43% and specificity of 62% for diagnosing DO.
- The area under the ROC curve was 0.53, indicating poor overall diagnostic accuracy.
- Likelihood ratios did not significantly support BWT as a diagnostic tool.
Conclusions:
- Bladder wall thickness (BWT) measurement via ultrasound is not an accurate replacement for urodynamics in diagnosing detrusor overactivity (DO).
- The findings suggest BWT should not be used as a standalone diagnostic test for DO in women presenting with OAB symptoms.
Keywords:
Bladder walldetrusor overactivity diagnostic accuracyoveractive bladderultrasoundurodynamicsMore Related Videos
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