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Ultrasound: a noninvasive screening test for detrusor instability


Correspondence: Dr V. Khullar, Urogynaecology Unit, Department of Obstetrics and Gynaecology, King's College Hospital, Bessemer Road, London SE5 9RS, UK.


Objective To determine whether transvaginal ultrasound measurement of bladder wall thickness can be used as a screening test for detrusor instability in women with urinary symptoms.

Design A blinded prospective study.

Setting A London teaching hospital.

Participants One hundred and eighty-four symptomatic women presenting to a urodynamic clinic.

Main outcome measure The detection of detrusor instability by means of videocystourethrography (VCU) and ambulatory urodynamics in women with a mean bladder wall thickness of greater than 5 mm measured by transvaginal ultrasound.

Results One hundred and eight women had a mean bladder wall thickness of greater than 5 mm. Ninety-four percent (102) of these women had detrusor instability either when undergoing VCU or ambulatory urodynamics. Seventeen women had a bladder wall thickness of less than 3.5 mm of whom three were found to have detrusor instability on VCU.

Conclusion The measurement of a mean bladder wall thickness greater than 5 mm with transvaginal ultrasound is a sensitive screening method for diagnosing detrusor instability in symptomatic women without outflow obstruction.