Ultrasound Estimated Bladder Weight Research Articles

Bladder Sonomorphological Tests in Diagnosing Bladder Outlet Obstruction in Patients with Lower Urinary Tract Symptoms: A Systematic Review and Meta-Analysis

Aims: We aimed to investigate the accuracy of bladder sonomorphological parameters including detrusor wall thickness (DWT) and ultrasound-estimated bladder weight (UEBW) for diagnosing bladder outlet obstruction (BOO) in patients with lower urinary tract symptoms (LUTS). Methods: A comprehensive search was conducted through databases including PubMed, EMBASE, MEDLINE, Cochrane Library, Medicine, China Knowledge Network (CNKI), China Biomedical Literature Database, Wanfang Database, the Chongqing VIP Chinese Science, and Technology Periodical Database (VIP) to select studies assessing the diagnostic accuracy of DWT and UEBW to diagnose BOO in adults with LUTS. Databases were searched from inception to 2020 without restriction. Study quality was assessed using Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2), and measures of accuracy were calculated using random-effects model. Results: The initial search included 84 publications, of which 78 publications were screened, and 16 studies with 1,847 patients finally contained diagnostic data. The results from 10 out of 16 studies assessing DWT showed a pooled sensitivity (SSY) of 0.68 (95% CI, 0.56–0.78) and specificity (SPY) of 0.91 (95% CI, 0.82–0.96) with I² values of 93%, while 6 studies evaluating UEBW were analyzed with a SSY of 0.88 (95% CI, 0.78–0.93) and SPY of 0.81 (95% CI, 0.67–0.90) with I² values of 83%. Conclusions: DWT shows high SPY, and UEBW performs high SSY of diagnosing BOO. Further well-designed studies are needed to evaluate the utilization of DWT and UEBW for the diagnosis of BOO.

Predicting the Outcome of Patients with Lower Urinary Tract Symptoms due to Benign Prostatic Hyperplasia Treated with Alpha Blocker Monotherapy by Measurement of Bladder and Prostate Parameters Using Ultrasound

AbstractBackground: Benign Prostatic Hyperplasia (BPH) is a condition intimately related to ageing. Although it is not life threatening, its clinical manifestation as Lower Urinary Tract Symptoms (LUTS) reduces the patient's quality of life.Aim of the Study: To determine prostate and bladder sonographic parameters that can predict the outcome of patients with LUTS/BPH treated by alpha 1a adrenoreceptor blocker monotherapy.Patients and Methods: Fifty patients complaining of LUTS/BPH were prospectively enrolled. Transrectal Ultra-sonography (TRUS) was done to all patients. Tamsulosin 0.4mg oral tablet was given to all patients once daily for 3 months then the response to treatment on the basis of Inter-national Prostatic Symptom Score (IPSS), Quality of Life (QoL) score and maximum urine flow rate (Qmax) was eval-uated. The impacts of baseline parameters on treatment out-come were statistically analyzed.Results: 45 patients completed the study. From them 15 patients (33.3%) had ineffective treatment. Pre treatment IPSS storage subscore, Qmax and TRUS measured parameters [Bladder Wall Thickness (BWT), Intravesical Prostatic Pro-trusion (IPP) and ultrasound estimated bladder weight (UEBW)] were the independent predictors of treatment failure. Receiver Operator characteristic (ROC) curves for parameters (BWT, UEBW and IPP) showed that Areas Under Curve (AUC) were (0.870, 0.908 and 0.836 respectively) at cut-off values of 9mm, 36g and 8.2mm. Using these cut-off values, the Positive Predictive Value (PPV) and Negative Predictive Value (NPV) were 75.0% and 97.6%; 72.4% and 96.0%; 67.5% and 95.0% for BWT, UEBW and IPP, respectively. Combination of these sono-morphologic parameters increased their positive predictive value to 76.39%.Conclusion: Combined use of sonographic parameters BWT, UEBW and IPP can predict alpha blocker monotherapy failure in BPH patients which aid in determining therapeutic plan and the need for further medical therapy or surgical intervention.

Subtle errors of bladder wall thickness measurement have a significant impact on the calculation of ultrasound-estimated bladder weight. A pilot study.

Ultrasound-estimated bladder weight (UEBW), is an emerging diagnostic tool, which has been used in both malesand females with lower urinary tract dysfunction. The currently acknowledged UEBW calculation methods rely on the accuratemeasurement of bladder wall thickness (BWT). We aim to identify if subtle errors in BWT measurement have a significantimpact on UEBW calculations. Twenty patients were randomly selected from an overactive bladderpatient cohort. The primary endpoint was to identify the range of false BWT measurements outside which significant changesin UEBW calculation occur. We used the Kojima method and a semi-automatic 3-D model that is based on Chalana's principle. Measurements were performed using the correct BWT and a series of faulty calculations from +0.5 mm to -0.5 mm using stepsof 0.05 mm from true BWT. The effect of a fixed 0.5 mm BWT error was checked in bladder volumes above and below 250 mland in three UEBW groups (<35 gr; 36-50 gr; >51gr). BWT measurement errors above 0.25 mm cause statistically significant changes in UEWB calculation when a 3-D model is used and errors above 0.15 mm when Kojima's method is used.At a fixed BWT error of 0.5 mm and bladder volume <250 ml, there is a 23.76% deviation from true UEBW, while at volumes>250 ml the deviation is 32.72%. The deviation is inversely proportional to the UEBW result, and heavier bladders deviateless. UEBW is a promising diagnostic tool, but small errors in BWT measurement might cause significant deviationfrom the true values. A 3-D calculation model appears to minimize such risks.

Ultrasound estimated bladder weight in the detection and post-operative follow-up of bladder outflow obstruction

This study was performed to standardize the ultrasound estimated bladder weight as an additional non-invasive test for the measurement of the bladder outflow obstruction and to measure the therapeutic effects of bladder outflow obstruction in the follow-up after surgical correction of obstruction. This study was conducted from December 2012 to May 2014 where the sample size was 55 and sampling technique was purposive. In bladder outflow obstruction patient, transabdominal sonography was performed using a 7.5 MHz. probe. The anterior bladder wall thickness was measured in three points in the midline 1 cm apart and the average value was recorded. After that bladder volume was measured by ultrasonogram. In pre- and post-operative groups ultrasound estimated bladder weight was measured from bladder wall thickness and bladder volume. In this study, the mean ± SD of age was 48.8 ± 15.0 years. In bladder outflow obstruction patient, the pre-operative ultrasound estimated bladder weight was 117 ± 45.1 g which was reduced to 53.9 ± 10.8 g three months after surgical correction of obstruction. The ultrasound estimated bladder weight is a non-invasive, cheap and easily available additional diagnostic tool for detecting bladder outflow obstruction as well as it can measure the therapeutic effects in post-operative period.

Non-invasive ultrasound measurements in male patients with LUTS and benign prostatic obstruction: implication for diagnosis and treatment

To evaluate the role of the ultrasound assessments of the bladder/detrusor wall thickness (BWT/DWT) and the ultrasound estimated bladder weight (UEBW) in lower urinary tract symptoms diagnosis and treatment. A systematic literature search from January 1995 until February 2016 was performed on PubMed using the following terms: "bladder weight", "bladder wall thickness", "detrusor wall thickness", "LUTS", "bladder outlet obstruction" (BOO), "benign prostatic obstruction". Additional references were obtained from the reference list of full-text manuscripts. Abstracts presented at the annual congresses of the European Association of Urology, American Urology Association and the International Continence Society were also included. BWT and DWT are accurate predictors of BOO. Despite several differences in the technique assessment, population characteristics and study design, the BWT/DWT accuracy for BOO was close to 90%. Furthermore, the ultrasound evaluation of bladder/detrusor thickness correlates positively with symptoms score and the main clinical parameters in BPH patients. Lastly, BWT and DWT have proved to be optimal predictor of response to medical/surgical treatment of lower urinary tract symptoms/benign prostatic obstruction (LUTS/BPO). However, the lack of standardization among the available studies marks these methods promising but still experimental and further studies are needed to clarify the standard methodology. The ultrasound evaluation of bladder/detrusor thickness appears to be simple, highly accurate and non-invasive technique to predict BOO and to evaluate the clinical outcomes after medical/surgical treatments for LUTS/BPH. The implementation of these techniques and their standardization will probably better define their role in the diagnostic algorithms of patients with LUTS and possibly reduce the number of unnecessary pressure flow-studies.

Can Bladder and Prostate Sonomorphology Be Used for Detecting Bladder Outlet Obstruction in Patients With Symptomatic Benign Prostatic Hyperplasia?

To investigate the accuracy of the bladder and prostate sonomorphologic parameters for the diagnosis of bladder outlet obstruction (BOO) in patients with lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH). First-visit men, aged ≥ 50 years, with LUTS/BPH were prospectively enrolled. Added to the initial basic evaluation, all patients underwent pelvic ultrasonography and pressure flow study. The pressure flow study was used as a reference standard for BOO, and according to its results, patients were divided into BOO and non-BOO groups. The sonomorphologic findings were compared between both groups, and the diagnostic accuracy of the significant parameters was determined. In total, 157 patients were included. Of these, 48 (30.57%) had BOO and 109 (69.43%) did not. Bladder wall thickness (BWT), ultrasound estimated bladder weight (UEBW), and intravesical prostatic protrusion (IPP) were the sonomorphologic parameters that differed significantly between both groups (P < .001). By receiver operating characteristic curve analysis, the optimal cutoff values distinguishing patients with BOO were BWT of 3.7 mm (area under the curve [AUC]: 0.940), UEBW of 31.5 g (AUC: 0.835), and IPP of 10.9 mm (AUC: 0.874). The sensitivity, specificity, and accuracy of BWT, UEBW, and IPP were 95.00%, 90.91%, and 93.55%; 75.44, 57.97%, and 65.62%; and 87.90%, 76.43%, and 82.17%, respectively. BWT, UEBW, and IPP measurements can be used to detect BOO in LUTS/BPH patients. The simple estimation of these sonomorphologic parameters by suprapubic approach makes these measurements potentially suitable methods to judge BOO noninvasively during the routine clinical evaluation of BPH.

Sonographic Parameters Predicting the Outcome of Patients With Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia Treated With Alpha1-Adrenoreceptor Antagonist

To define prostate and bladder sono-morphologic parameters that best predict the outcome of benign prostatic hyperplasia (BPH) in men treated with alpha1-adrenoreceptor antagonist. Patients with BPH, candidates for medical treatment, were prospectively enrolled. Besides basic evaluation measures, all patients underwent transrectal ultrasonography. The main outcome was the response to treatment on the basis of International Prostatic Symptom Score, quality of life score, and maximum urine flow rate after taking daily oral dose of tamsulosin 0.4 mg for 6 months. The influences of baseline parameters on treatment response were statistically analyzed. A total of 166 patients completed the study. From these, 59 (35.5%) had ineffective treatment after 6 months. According to logistic regression analysis, baseline International Prostatic Symptom Score storage subscore, maximum urine flow rate, and transrectal ultrasonography-measured sono-morphologic parameters (bladder wall thickness [BWT], ultrasound estimated bladder weight [UEBW], and intravesical prostatic protrusion [IPP]) were the independent predictors of ineffective treatment (P < .05). Using receiver operating characteristics analysis, BWT, UEBW, and IPP had adequate area under the curve (0.939, 0.897, and 0.876, respectively). At cutoff values of 9.3 mm, 34.5 g, and 12.9 mm, the positive and negative predictive values for BWT, UEBW, and IPP were 83.6% and 92.4%; 78.2% and 85.6%; 80.3% and 90.5%; respectively. Combination of these sono-morphologic parameters increased their positive predictive value to 97.6%. Sonographic measurements of BWT, UEBW, and IPP might aid in determining patients with BPH at high risk of alpha1-adrenoreceptor antagonist monotherapy failure, in turn determining the initial need for additional medical therapy or surgical intervention.

Imaging assessments of lower urinary tract dysfunctions: Future steps.

Urodynamic tests are the standard diagnostic method for lower urinary tract dysfunctions (LUTD). However, these tests are invasive. The current review describes the noninvasive imaging techniques that have been used to monitor LUTD. The main imaging technologies that have been applied in diagnosing LUTD were 2D ultrasonography, Doppler ultrasonography, and near-infrared spectroscopy (NIRS). Ultrasonographic parameters, such as bladder wall thickness (BWT), detrusor wall thickness (DWT), and ultrasound-estimated bladder weight (UEBW), have been proposed as surrogates for bladder outlet obstruction (BOO) or detrusor overactivity (DO). Few studies have reported diagnostic cut-offs in diagnosing BOO or DO; thus, there is still a need to standardize the measurement method. NIRS can detect the hemodynamic changes related to DO and BOO in real-time, which could be advantageous in clinical practice, but the liability of NIRS to motion artefacts is a limitation. Bladder strain imaging in real-time using 2D ultrasound enables noninvasive estimation of the dynamic changes in the bladder wall during voiding. Many imaging techniques have been used to monitor the urinary bladder during the storage and voiding phases of the micturition cycle. These techniques were either static [i.e., measuring fixed parameters, such as BWT, DWT, UEBW, and intravesical prostatic protrusion (IVPP)] or dynamic (monitoring the structural and hemodynamic changes in the bladder wall in real-time). These techniques are currently being developed and standardized for potential use in diagnosing LUTD in clinical practice.

Assessment of BPH/BOO.

The assessment of men with bladder outflow obstruction relies on an adequate history and examination. Uroflowmetry and post-void residue estimation are very revealing and may be sufficient in the majority of men. The prostate-specific antigen test may be used to select men who are at a high risk of progression. In specific situations, cystometry may be required. We discuss the use of cystometry and the newer less-invasive methods of assessment that have emerged over the last few years, including ultrasound estimation of intravesical prostatic protrusion, prostatic urethra angle, detrusor wall thickness, ultrasound-estimated bladder weight, near-infrared spectroscopy and the condom catheter and penile cuff tests. Although these techniques show promise, they still require further modifications, standardization and testing in larger populations. In addition, they should be used in men where only specific questions need to be answered.

Current State of the Art in Non-Invasive Urodynamics

Lower urinary tract symptoms (LUTS) are highly prevalent and bothersome. The pressure flow or voiding part of urodynamics gives information regarding detrusor contractility and whether bladder outlet obstruction (BOO) is present. However, urodynamics are invasive and can be associated with infection and take time to perform. Moreover it is not clear whether urodynamics are beneficial in assessing LUTS routinely or whether they are able to predict outcomes following surgery for obstruction. As a result several non-invasive techniques and investigations have been developed to try to aid in the work up and management of patients with LUTS / BPE. A PubMed search was performed to review the literature on non-invasive urodynamic tests for voiding dysfunction. Techniques include transition zone index, intravesical prostatic protrusion, prostate circle area ratio, prostatic urethral angle, resistive index, bladder wall and detrusor wall thickness, ultrasound estimated bladder weight, near infrared spectroscopy, condom catheter and penile cuff compression techniques and are summarized in this review.

Re: Predictive value of resistive index, detrusor wall thickness and ultrasound estimated bladder weight regarding the outcome after transurethral prostatectomy for patients with lower urinary tract symptoms suggestive of benign prostatic obstruction

Re: Predictive value of resistive index, detrusor wall thickness and ultrasound estimated bladder weight regarding the outcome after transurethral prostatectomy for patients with lower urinary tract symptoms suggestive of benign prostatic obstruction

Ultrasound estimated bladder weight in asymptomatic adult females.

To estimate the bladder weight by automated ultrasound method (BladderScan BVM 9500) in adult females without lower urinary tract symptoms and to assess both the intra-observer and interobserver reproducibility of this method. Healthy volunteers were recruited in King Khalid University Hospital from hospital staff and patients attending the gynecological clinic over a period of six months. All women were screened for any lower urinary tract symptoms using a validated short version of Urinary Distress Inventory questionnaire. BladderScan BVM 9500 device (Diagnostic Ultrasound, Bothell, WA) was used to measure bladder wall thickness, bladder volume, and calculated bladder weight. Eighty-five women were included in the study. The mean age was 37.5 years (± 11.1). Mean bladder wall thickness (BWT) was 1.68 mm (95% confidence interval: 1.61 to 1.75) and the mean ultrasound-estimated bladder weight (UEBW) was 32.25 g (95% confidence interval: 31.7 to 32.8). The UEBW intra-observer (ICC: 0.81) and interobserver (ICC: 0.8) reproducibility were excellent while intra-observer (ICC: 0.55) and interobserver (ICC: 0.6) reproducibility for BWT were moderate. No correlation was found between UEBW and age, height, body weight, or bladder volume. The estimated bladder weight by automated ultrasound device in asymptomatic adult females yields reproducible measurements and can be used as a reference for future understanding of the changes in bladder weight related to different types of urinary incontinence or voiding disorders.

Correlation of Ultrasound-estimated Bladder Weight to Urodynamic Diagnoses in Women With Lower Urinary Tract Symptoms

To test the hypothesis that the ultrasound-estimated bladder weight (UEBW) will correlate with the urodynamic diagnoses in women with lower urinary tract symptoms, in particular, detrusor underactivity and bladder outflow obstruction. Ultrasonography has been increasingly used in the assessment of lower urinary tract conditions. Adult women referred to the urodynamics suite for investigation of lower urinary tract symptoms were enrolled. After urodynamic evaluation, the portable BladderScan BVM 6500 device was used to calculate the bladder wall thickness and UEBW according to a standardized protocol. The patients were categorized according to the urodynamic findings. Women with normal findings, despite the symptoms for which they were referred, were used as the control group. The UEBW and bladder wall thickness measurements were compared between the groups and controls, using the Mann-Whitney and Kolmogorov-Smirnov tests. P <.05 was considered statistically significant. A total of 187 women were enrolled. The UEBW was significantly lower in the patients with detrusor underactivity than in the controls (39.3 ± 3.0 g vs 45.7 ± 3.1 g, P <.001). Significant differences were also noted between the controls and patients with bladder outflow obstruction, with or without detrusor overactivity (45.7 ± 3.1 g vs 52.1 ± 3.9 g and 52.3 ± 6.2 g, respectively; P <.001 for both). The difference, in terms of the UEBW, between controls and patients with detrusor overactivity was not statistically significant (45.7 ± 3.1 g vs 45.3 ± 3.0, P > .05). A significantly reduced UEBW in female patients with detrusor underactivity and a significantly increased UEBW in patients with bladder outflow obstruction were found. However, the finding of a significantly increased bladder weight in patients with detrusor overactivity was not confirmed in the present study.

Predictive value of resistive index, detrusor wall thickness and ultrasound estimated bladder weight regarding the outcome after transurethral prostatectomy for patients with lower urinary tract symptoms suggestive of benign prostatic obstruction

To evaluate the value of three parameters from preoperative ultrasonography in predicting the outcome of transurethral prostatectomy in patients with lower urinary tract symptoms suggestive of benign prostatic obstruction. A total of 239 patients with lower urinary tract symptoms suggestive of benign prostatic obstruction entering our department for surgical therapy were prospectively recruited. All of them underwent both ultrasound and urodynamics before receiving standard transurethral prostatectomy by the same team of surgeons. For 202 patients, 6-month follow-up data were available after the surgery, including the International Prostate Symptom Score, the Quality of Life score and the maximum flow rate. Preoperative data stratified by different degree of recovery were compared and the influence of ultrasound parameters on the surgical outcome was analyzed by using logistic regression and receiver-operator characteristic curve analyses. Baseline transitional zone index, intravesical prostatic protrusion, resistive index, detrusor wall thickness and ultrasonic estimation of bladder weight were significantly different between patients with an effective outcome and those with an ineffective outcome (P < 0.05). Resistive index, detrusor wall thickness and ultrasonic estimation of bladder weight were selected as independent factors correlated with the efficacy of transurethral prostatectomy by logistic regression (P < 0.05). All three factors had adequate area under receiver-operator characteristic curve with resistive index having the largest area (0.816, 95% CI 0.759-0.874). The combined positive predictive value in effective surgical outcome of resistive index, detrusor wall thickness and ultrasonic estimation was 96.3%. Resistive index, detrusor wall thickness and ultrasonic estimation adequately predict the outcome of transurethral prostatectomy. Measuring these parameters by preoperative ultrasound might aid in determining the need for surgical intervention.

Tamsulosin Efficiency in Treatment of Benign Prostatic Hyperplasia Evaluated by Determining Bladder Weight

INTRODUCTION/GOAL: Bladder wall thickness and bladder mass are higher in patients with subvesical obstruction caused by benign prostate enlargement (BPE) in compensated stage of the disease. The goal of the study was to determine changes of bladder detrusor in patients suffering from benign prostatic hyperplasia (BPH) during tamsulosin treatment. The study was open, prospective and multi-centric. The material in this study was composed of 20 patients, aged > 45 years, with the present lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia, who had not been treated for the previous 3 months. The inclusive criteria also included the value of International Prostate Symptom Score (IPSS) > or = 8 points, post-void residual urine volume (PVR) < 100 ml and prostate specific antigen (PSA) < 4 ng/ml. After the end of the trials that were necessary for the introduction of the patients in the study, the patients started taking tamsulosin in a daily dosage of 0.4 mg, and the evaluation parameters during the research were measured at time intervals of 4, 12 and 24 weeks. The evaluation parameters were primary and secondary. The primary parameter included ultrasound estimated bladder weight (UEWB), while the secondary included determination of the blood pressure values (RR) and pulse frequency (PF), of total International Prostate Symptom Score (T-IPSS), a part of IPSS that related to the storage symptoms (I-PSS), a part that related to the voiding symptoms (O-IPSS), quality of life determination (IPSS-QoL), ultrasound estimation of prostate volume (VP) and the quantity of post-void residual urine volume (PVR), along with the determination of the number and strength of adverse reactions. During the introduction of the patients in the trial, the arithmetic mean of UEWB was 65 g, of PVR 43 ml, VP 35 ml, of total T-IPSS 15.6 points, of I-IPSS 6.9 points, of O-IPSS 8.7 points, and of IPSS-QoL 3.6 points. During the four-week, twelve-week and twenty-four-week checkups, the values were the following: the arithmetic mean of UEWB 36, 39 and 28 grams, of PVR 26, 29 and 21 ml, of T-IPSS 8.3, 6.4 and 5.0 points, of IPSS 3.8, 3.0 and 2.4 points, of O-IPSS 4.6, 3.4 and 2.6 points, of IPSS-QoL 1.7, 1.1 and 1.0 points and of VP 34 ml during the last control. The obtained results of this trial were processed by descriptive statistics (arithmetic mean and standard deviation) and analytical statistics by way of Student's t-test for dependant (paired) samples, with the comparison made between the obtained results with the zero checkup and four-week checkup, and subsequently the comparison between four-week and twelve-week checkup, twelve-week and twenty-four week checkup, and the zero checkup and the twenty-four week checkup. Adverse drug reactions (libido and ejaculation problems 5% and headache 5%) were mild and tolerant and did not require the interruption of the therapy. During a 24-week treatment of benign prostatic hyperplasia with tamsulosin, the same showed clinical efficiency in the sense of improvement of LUTS and a decrease of bladder outlet obstruction (BOO), without the influence on prostate volume or showing statistically significant vasodilatory effect. The same affected a significant decrease of ultrasound estimated bladder weight (from 65 g to 28 g).

Ultrasound Estimated Bladder Weight and Measurement of Bladder Wall Thickness-Useful Noninvasive Methods for Assessing the Lower Urinary Tract?

Ultrasound Estimated Bladder Weight and Measurement of Bladder Wall Thickness-Useful Noninvasive Methods for Assessing the Lower Urinary Tract?

Ultrasound estimated bladder weight in men attending the uroflowmetry clinic

To determine if measurements of ultrasound estimated bladder weight (UEBW) provide an additional diagnostic tool when assessing men with lower urinary tract symptoms (LUTS) in the uroflowmetry clinic. One hundred men with LUTS attending the uroflowmetry clinic underwent transabdominal ultrasound measurement of bladder weight, using the BVM 9500 bladder scanner (Verathon Medical, Bothell, WA). These data were explored for any correlation between measurements of maximum flow rate (Q(max)) with UEBW, age, height, weight, body mass index (BMI), ICIQ M-LUTS score, M-LUTS voiding score, M-LUTS incontinence score, IPSS, IPSS quality of life score, voided volume, and post-void residual urine. Based on previously reported probabilities of bladder outlet obstruction (BOO), patients were grouped for analysis (Group 1 = Q(max) <10, Group 2 = Q(max) 10-15, Group 3 = Q(max) >15). A one-way ANOVA was undertaken to assess any difference in mean UEBW between the three groups. Statistically significant negative correlations between Q(max) and age (r = -0.308, P = 0.002), M-LUTS voiding score (r = -0.298, P = 0.003), IPSS (r = -0.295, P = 0.003), and post-void residual (r = -0.213, P = 0.033) were observed. A statistically significant positive correlation between Q(max) and voided volume (r = 0.503, P < 0.01) was observed. No association between Q(max) and UEBW was observed (r = 0.12, P = 0.243). Mean UEBW for the three groups was remarkably similar. One-way ANOVA identified there was no statistically significant effect of UEBW on Q(max) F(2, 97) = 0.175, P = 0.840. Mean UEBW did not differ significantly between the three Q(max) groups. Further work is required to investigate the relationship of Q(max) and UEBW in men with urodynamic confirmation of either BOO or detrusor underactivity.

The Diagnostic Efficacy of 3-Dimensional Ultrasound Estimated Bladder Weight Corrected for Body Surface Area as an Alternative Nonurodynamic Parameter of Bladder Outlet Obstruction

We investigated the relationship between ultrasound estimated bladder weight/corrected ultrasound estimated bladder weight and the bladder outlet obstruction index derived from pressure flow study to evaluate its diagnostic efficacy to predict bladder outlet obstruction. A total 193 men older than 50 years with lower urinary tract symptoms were enrolled in this study. Ultrasound estimated bladder weight measurements were made with a 3-dimensional ultrasound system. Corrected bladder weight was defined as ultrasound estimated bladder weight divided by body surface area on data analysis. The study population was classified into obstructed and unobstructed groups (bladder outlet obstruction index 40 or greater and less than 40, respectively). We evaluated the correlation between bladder outlet obstruction and clinical parameters, including bladder weight/corrected bladder weight and the diagnostic accuracy of bladder weight/corrected bladder weight for bladder outlet obstruction. A total of 50 (26%) and 143 patients (74%) were categorized as obstructed and nonobstructed, respectively. Corrected bladder weight, maximum urine flow and the bladder contraction index showed statistically significant differences between the groups. Bladder weight/corrected bladder weight positively correlated with the bladder outlet obstruction index and corrected bladder weight showed a stronger correlation. Corrected bladder weight was significantly increased depending on obstruction severity. When corrected bladder weight was used to diagnose obstruction, sensitivity, specificity, and positive and negative predictive values were 61.9%, 59.8%, 33.8% and 82.6%, respectively, at a 28 gm/m(2) cutoff. Ultrasound estimated bladder weight/corrected ultrasound estimated bladder weight is a statistically significant parameter correlating with bladder outlet obstruction. However, bladder weight/corrected bladder weight alone was insufficient to predict bladder outlet obstruction due to its weak correlation with and low accuracy for diagnosing obstruction.

Ultrasound estimated bladder weight in men attending the uroflowmetry clinic

Aims To determine if measurements of ultrasound estimated bladder weight (UEBW) provide an additional diagnostic tool when assessing men with lower urinary tract symptoms (LUTS) in the uroflowmetry clinic. Methods One hundred men with LUTS attending the uroflowmetry clinic underwent transabdominal ultrasound measurement of bladder weight, using the BVM 9500 bladder scanner (Verathon Medical, Bothell, WA). These data were explored for any correlation between measurements of maximum flow rate (Qmax) with UEBW, age, height, weight, body mass index (BMI), ICIQ M-LUTS score, M-LUTS voiding score, M-LUTS incontinence score, IPSS, IPSS quality of life score, voided volume, and post-void residual urine. Based on previously reported probabilities of bladder outlet obstruction (BOO), patients were grouped for analysis (Group 1 = Qmax 15). A one-way ANOVA was undertaken to assess any difference in mean UEBW between the three groups. Results Statistically significant negative correlations between Qmax and age (r = −0.308, P = 0.002), M-LUTS voiding score (r = −0.298, P = 0.003), IPSS (r = −0.295, P = 0.003), and post-void residual (r = −0.213, P = 0.033) were observed. A statistically significant positive correlation between Qmax and voided volume (r = 0.503, P < 0.01) was observed. No association between Qmax and UEBW was observed (r = 0.12, P = 0.243). Mean UEBW for the three groups was remarkably similar. One-way ANOVA identified there was no statistically significant effect of UEBW on QmaxF(2, 97) = 0.175, P = 0.840. Conclusion Mean UEBW did not differ significantly between the three Qmax groups. Further work is required to investigate the relationship of Qmax and UEBW in men with urodynamic confirmation of either BOO or detrusor underactivity. Neurourol. Urodynam. 30:583–586, 2011. © 2011 Wiley-Liss, Inc.

Ultrasound estimated bladder weight and measurements of bladder wall thickness in healthy asymptomatic men

Ultrasound estimated bladder weight and measurements of bladder wall thickness in healthy asymptomatic men