Ultrasound: a noninvasive screening test for detrusor instability

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Abstract
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.