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Bladder wall thickness measured by CT can predict bladder outlet obstruction in men: a retrospective cohort study. Int Urol Nephrol 2023; 55:43-49. [PMID: 36103042 DOI: 10.1007/s11255-022-03361-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 09/01/2022] [Indexed: 01/05/2023]
Abstract
PURPOSE To evaluate whether bladder wall thickness (BWT) measured by CT can be used to predict bladder outlet obstruction in men with low urinary tract symptoms (LUTS). METHODS From 2015 to 2018, a total of 120 men with lower urinary tract symptoms who underwent both urodynamic studies and CT tests of the lower abdomen or pelvis were involved. Bladder wall thickness values were measured by CT scanning. RESULTS Based on the urodynamic studies, 120 men were categorized into two groups, including 70/120 men (58.3%) in the bladder outlet obstruction (BOO) group and 50/120 men (41.7%) in the non-BOO group. The mean BWT was thicker in the BOO group than in the non-BOO group (3.87 vs. 2.75 mm, p < 0.001). The mean maximum bladder capacity (MBC) was lower in the BOO group than in the non-BOO group (263.42 vs. 308.96 ml, p < 0.001). The mean detrusor pressure at maximum urinary flow rate (PdetQmax) was higher in the patients in the BOO group than in those in the non-BOO group (102.28 vs. 49.25 cmH2O, p < 0.001). The ROC curve showed that BWT was a good predictor with an AUC of 0.855 (95% CI 0.785-0.924, p < 0.001). At the cutoff value of 3.20 mm, the predictive sensitivity of BWT for BOO was 72.9%, and the specificity was 90%. CONCLUSION Increased bladder wall thickness was correlated with bladder outlet obstruction in men with LUTS. Bladder wall thickness measured by CT scans may be a noninvasive parameter to predict bladder outlet obstruction in men with LUTS.
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Cheng Y, Li T, Wu X, Ling Q, Rao K, Yuan X, Chen Z, Du G, Xu S. The diagnostic value of non-invasive methods for diagnosing bladder outlet obstruction in men with lower urinary tract symptoms: A meta-analysis. Front Surg 2022; 9:986679. [PMID: 36338622 PMCID: PMC9632994 DOI: 10.3389/fsurg.2022.986679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 09/05/2022] [Indexed: 11/26/2022] Open
Abstract
Purpose We conducted the first meta-analysis to determine the diagnostic value of non-invasive methods for diagnosing bladder outlet obstruction (BOO) in men with lower urinary tract symptoms (LUTS). Methods We searched a range of databases for relevant publications up to June 2022, including PubMed, Embase, Web of Science, and the Cochrane Library. Retrieved studies were then reviewed for eligibility and data were extracted. The risk of bias (RoB) was assessed using the QUADAS-2 tool. We then performed a formal meta-analysis to evaluate the accuracy of various non-invasive methods for diagnosing BOO in men. Results We identified 51 eligible studies including 7,897 patients for meta-analysis. The majority of the studies had a low overall RoB. Detrusor wall thickness (DWT) (pooled sensitivity (SSY): 71%; specificity (SPY): 88%; diagnostic odds ratio (DOR): 17.15; area under curve (AUC) 0.87) and the penile cuff test (PCT) (pooled SSY: 87%; SPY: 78%; DOR: 23.54; AUC: 0.88) showed high accuracy for diagnosing BOO. Furthermore, data suggested that DWT had the highest pooled SPY (0.89), DOR (32.58), and AUC (0.90), when using 2 mm as the cut-off. Conclusion Of the non-invasive tests tested, DWT and PCT had the highest levels of diagnostic accuracy for diagnosing BOO in men with LUTS. DWT, with a 2 mm cut-off, had the highest level of accuracy. These two methods represent good options as non-invasive tools for evaluating BOO in males.
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Anzia LE, Johnson CJ, Mao L, Hernando D, Bushman WA, Wells SA, Roldán-Alzate A. Comprehensive non-invasive analysis of lower urinary tract anatomy using MRI. Abdom Radiol (NY) 2021; 46:1670-1676. [PMID: 33040167 DOI: 10.1007/s00261-020-02808-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 09/28/2020] [Accepted: 09/30/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE Anatomic changes that coincide with aging including benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS) negatively impact quality of life. Use of MRI with its exquisite soft tissue contrast, full field-of-view capabilities, and lack of radiation is uniquely suited for quantifying specific lower urinary tract features and providing comprehensive measurements such as total bladder wall volume (BWV), bladder wall thickness (BWT), and prostate volume (PV). We present a technique for generating 3D anatomical renderings from MRI to perform quantitative analysis of lower urinary tract anatomy. METHODS T2-weighted fast-spin echo MRI of the pelvis in 117 subjects (59F;58 M) aged 30-69 (49.5 ± 11.3) without known lower urinary tract symptoms was retrospectively segmented using Materialise software. Virtual 3D models were used to measure BWV, BWT, and PV. RESULTS BWV increased significantly between the 30-39 and 60-69 year age group in women (p = 0.01), but not men (p = 0.32). BWV was higher in men than women aged 30-39 and 40-49 (p = 0.02, 0.05, respectively) ,but not 50-59 or 60-69 (p = 0.18, 0.16, respectively). BWT was thicker in men than women across all age groups. Regional differences in BWT were observed both between men and women and between opposing bladder wall halves (anterior/posterior, dome/base, left/right) within each sex in the 50-59 and 60-69 year groups. PV increased from the 30-39 to 60-69 year groups (p = 0.05). BWT was higher in subjects with enlarged prostates (> 40cm3) (p = 0.05). CONCLUSION Virtual 3D MRI models of the lower urinary tract reliably quantify sex-specific and age-associated changes of the bladder wall and prostate.
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Affiliation(s)
- Lucille E Anzia
- Departments of Radiology, School of Medicine and Public Health, University of Wisconsin, Madison, USA
- Departments of Mechanical Engineering, School of Medicine and Public Health, University of Wisconsin, 1513 University Avenue Rm 3035, Madison, WI, 53706, USA
| | - Cody J Johnson
- Departments of Radiology, School of Medicine and Public Health, University of Wisconsin, Madison, USA
- Departments of Mechanical Engineering, School of Medicine and Public Health, University of Wisconsin, 1513 University Avenue Rm 3035, Madison, WI, 53706, USA
| | - Lu Mao
- Departments of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin, Madison, USA
| | - Diego Hernando
- Departments of Radiology, School of Medicine and Public Health, University of Wisconsin, Madison, USA
- Departments of Medical Physics, School of Medicine and Public Health, University of Wisconsin, Madison, USA
| | - Wade A Bushman
- Departments of Urology, School of Medicine and Public Health, University of Wisconsin, Madison, USA
| | - Shane A Wells
- Departments of Radiology, School of Medicine and Public Health, University of Wisconsin, Madison, USA
| | - Alejandro Roldán-Alzate
- Departments of Radiology, School of Medicine and Public Health, University of Wisconsin, Madison, USA.
- Departments of Mechanical Engineering, School of Medicine and Public Health, University of Wisconsin, 1513 University Avenue Rm 3035, Madison, WI, 53706, USA.
- Departments of Biomedical Engineering, School of Medicine and Public Health, University of Wisconsin, Madison, USA.
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Farag FF. Re: A prototype non-invasive urodynamic test to estimate voiding reserve in normal adult males. By Shafik Shoukry, Mostafa Elmissiry, Ahmed Abulfotooh, Ahmed Moussa, Wally Mahfouz, Waleed Dawood, Aly Abdel-Karim and Mohamed Hassouna. Arab J Urol 2019; 17:258. [PMID: 31725131 PMCID: PMC6830199 DOI: 10.1080/2090598x.2019.1642620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 07/01/2019] [Indexed: 11/01/2022] Open
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Swavely NR, Speich JE, Stothers L, Klausner AP. New Diagnostics for Male Lower Urinary Tract Symptoms. CURRENT BLADDER DYSFUNCTION REPORTS 2019; 14:90-97. [PMID: 31938079 PMCID: PMC6959483 DOI: 10.1007/s11884-019-00511-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE OF REVIEW Lower urinary tract symptoms (LUTS) is a common constellation of symptoms that affect the aging male population with an astonishing prevalence. New technology and new uses of established technology are being used to help further evaluate LUTS in the male population and help guide treatment options. This review focuses on the developments and future directions in diagnostic modalities for evaluation of male LUTS, focusing on evaluation of both the filling and voiding phases of micturition. RECENT FINDINGS New techniques in evaluating the voiding phase include penile cuff test, external pressure sensing condom catheter, ultrasound measurement of detrusor wall thickness, ultrasound measurement of intravesical prostatic protrusion, doppler ultrasound and NIRS technology. Evaluation of the filling phase is still undergoing much development and requires additional validation studies. The techniques undergoing evaluation include sensation meters during UDS, assessing bladder micromotion and wall rhythm, assessing detrusor wall biomechanics, ultrasound measurement of detrusor wall thickness, pelvic doppler ultrasound, as well as functional brain imaging including fNIRS and fMRI. SUMMARY The development of novel, non-invasive, diagnostic tools have the potential for better evaluation of LUTS with earlier and enhanced treatments. This will likely improve the quality of life for men with LUTS.
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Affiliation(s)
- Natalie R Swavely
- Department of Surgery/Division of Urology, Virginia Commonwealth University School of Medicine, Richmond, VA
| | - John E Speich
- Department of Mechanical & Nuclear Engineering, Virginia Commonwealth University College of Engineering, Richmond, VA
| | - Lynn Stothers
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Adam P Klausner
- Department of Surgery/Division of Urology, Virginia Commonwealth University School of Medicine, Richmond, VA
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Gravas S, Kyriazis I, Klausner AP. Lower Urinary Tract Symptoms Including Bladder Outlet Obstruction: What’s New in Diagnostics? Eur Urol Focus 2018; 4:14-16. [DOI: 10.1016/j.euf.2018.04.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 03/12/2018] [Accepted: 04/01/2018] [Indexed: 02/07/2023]
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