Clinical usefulness of ultrasound assessment of detrusor wall thickness in patients with neurogenic lower urinary tract dysfunction due to spinal cord injury: urodynamics made easy?

Abstract

To evaluate the clinical usefulness of sonographic measurement of detrusor wall thickness (DWT) for the prediction of risk factors in patients with neurogenic lower urinary tract dysfunction (NLUTD) due to spinal cord injury (SCI). In a prospective study, 60 consecutive patients with NLUTD due to SCI presenting for routine urodynamic assessment at a specialized SCI center underwent additional measurement of DWT at varying bladder volumes. Results of urodynamic testing were classified into favorable and unfavorable. DWT at maximum capacity was used to calculate a possible cutoff value for favorable urodynamic results. Urodynamic results were favorable in 48 patients and unfavorable in 12 patients. A DWT of 0.97 mm or less can safely (sensitivity 91.7 %, specificity 63.0 %) be used as a cutoff point for the absence of risk factors for renal damage. According to our results, DWT may be useful as an additional risk assessment for renal damage in patients with NLUTD due to SCI. However, as other parameters required for bladder management, especially detrusor overactivity, cannot be evaluated by this technique, it cannot replace urodynamic testing.