Division of Urology, Department of Surgery, Far Eastern Memorial Hospital, Ban Ciao, Taipei, Taiwan.
BJU Int. 2010 Mar;105(5):668-72. doi: 10.1111/j.1464-410X.2009.08927.x. Epub 2009 Sep 29.
To determine the clinical usefulness of measuring detrusor wall thickness (DWT) as a noninvasive test in women with overactive bladder (OAB).
PATIENTS, SUBJECTS AND METHODS: We prospectively enrolled 122 women with dry OAB, wet OAB, and women with no OAB symptoms (control group). A 3-day voiding diary was used to differentiate between wet and dry OAB. Transabdominal ultrasonography (TAUS) measurements of DWT were taken at bladder volumes of 250-300 mL and the maximal bladder capacity by both catheter- and natural-filling. Video-urodynamic studies (VUDS) were used to classify bladder dysfunction in 88 of the women.
The mean (range) age of the women was 58 (20-94) years. There were 39 'normal' controls, 44 women had dry OAB, and 39 had wet OAB. Of the 88 women who had VUDS, 28 had a 'normal' test, 30 had increased bladder sensation (IBS), and 30 had detrusor overactivity (DO). The mean DWT at 250-300 mL among three symptomatic subgroups or urodynamic subgroups showed no significant difference by either catheter- or natural-filling methods. The women with wet OAB had significantly greater DWTs than the controls at maximal bladder volume. The maximal bladder capacity was significantly greater in 'normal' women than in those with OAB. If we corrected maximal bladder volume to 250 mL, DWT at corrected 250 mL showed no significant difference among three symptomatic subgroups.
DWT measured by TAUS in women with OAB and without OAB was not different and did not differ with urodynamic status. Thus, TAUS measurement of DWT is not recommended as a useful diagnostic test for DO in women with OAB.
确定测量逼尿肌壁厚度（DWT）作为一种非侵入性测试在女性膀胱过度活动症（OAB）的临床应用。
患者、受试者和方法：我们前瞻性地招募了 122 例有干燥性 OAB、湿性 OAB 和无 OAB 症状的女性（对照组）。使用 3 天排尿日记来区分干湿 OAB。在膀胱容量为 250-300mL 时，通过经腹超声（TAUS）测量 DWT，并通过导管和自然填充测量最大膀胱容量。对 88 例女性进行视频尿动力学研究（VUDS）以分类膀胱功能障碍。
女性的平均（范围）年龄为 58（20-94）岁。有 39 例“正常”对照组，44 例有干燥性 OAB，39 例有湿性 OAB。在 88 例进行 VUDS 的女性中，28 例测试正常，30 例有膀胱感觉增加（IBS），30 例有逼尿肌过度活动（DO）。在 3 个症状亚组或尿动力学亚组中，使用导管或自然填充方法测量的 250-300mL 时的平均 DWT 无显著差异。在最大膀胱容量时，湿性 OAB 女性的 DWT 明显大于对照组。“正常”女性的最大膀胱容量明显大于 OAB 女性。如果我们将最大膀胱容量校正为 250mL，校正后 250mL 时的 DWT 在 3 个症状亚组中无显著差异。
在有 OAB 和无 OAB 的女性中，TAUS 测量的 DWT 没有差异，与尿动力学状态也没有差异。因此，TAUS 测量 DWT 不建议作为 OAB 女性 DO 的有用诊断测试。
