Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China.
Urol Int. 2023;107(4):327-335. doi: 10.1159/000519102. Epub 2021 Dec 13.
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).
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.
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%.
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.
本研究旨在探讨膀胱形态学参数（包括逼尿肌厚度[DWT]和超声估计膀胱重量[UEBW]）在诊断下尿路症状（LUTS）患者膀胱出口梗阻（BOO）中的准确性。
通过检索 PubMed、EMBASE、MEDLINE、Cochrane 图书馆、Medicine、中国知网（CNKI）、中国生物医学文献数据库、万方数据库、重庆维普中文科技期刊数据库（VIP）等数据库，全面检索评估 DWT 和 UEBW 诊断成人 LUTS 患者 BOO 准确性的研究。检索时间从建库至 2020 年，无任何限制。使用 QUADAS-2 评估研究质量，并使用随机效应模型计算准确性指标。
最初检索到 84 篇文献，经筛选后有 78 篇文献被排除，最终纳入 16 项研究共 1847 例患者，这些研究均包含诊断数据。16 项研究中有 10 项评估 DWT，其汇总敏感度（SSY）为 0.68（95%CI，0.56-0.78），特异性（SPY）为 0.91（95%CI，0.82-0.96），I²值为 93%；6 项研究评估 UEBW，SSY 为 0.88（95%CI，0.78-0.93），SPY 为 0.81（95%CI，0.67-0.90），I²值为 83%。
DWT 具有较高的 SPY，UEBW 对诊断 BOO 的 SSY 较高。需要进一步开展精心设计的研究来评估 DWT 和 UEBW 用于诊断 BOO 的应用价值。
