Bladder Wall Thickness in Overactive Bladder: Does It Have a Role?

Abstract: Context: Overactive bladder syndrome (OAB) is a highly prevalent condition. Urodynamics have long been the only option, and still remain the gold standard, for examining people with OAB complaints and composing an appropriate treatment plan. Alternatives for this invasive, expensive, and time-consuming examination have been explored. Objective: To review if bladder wall thickness (BWT) could be a more objective and easier measurement that potentially could diagnose OAB and be used to analyse treatment response. Evidence acquisition: Proposed and opposed arguments on the role of BWT in OAB were discussed during the seminar, “The Great Bladder Wall Thickness Debate: Tearing It Down Brick by Brick,” at the 2nd World Congress on Controversies in Urology (CURy) in Lisbon, Portugal. Those arguments are summarised in this paper. Evidence synthesis: The assessment of BWT (ie, the thickness of the mucosa layer, detrusor muscle, and adventitia) is an indirect measure of detrusor muscle thickness. There is no standard method of measuring BWT. In a Web-based survey conducted before the congress, 49% of the physicians who participated agreed that BWT has a role in OAB; at the end of the debate, the survey question was repeated to the participants of the session and only 20% agreed that BWT has a role in OAB in clinical practice today. Conclusions: At the moment, there is no standardised method of measuring BWT. Assessing BWT with ultrasonography is a very appealing concept for research purposes, but more studies are needed before it will become a tool in daily clinical practice. [Copyright &y& Elsevier]