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. 2024 Apr 17;86(6):3249-3254.
doi: 10.1097/MS9.0000000000002062. eCollection 2024 Jun.

Association of detrusor wall thickness (DWT) with lower urinary tract symptom severity in benign prostatic hyperplasia: a cross-sectional study

Kishor Bhattarai  1 , Hensan Khadka  1 , Bikash Raj Thapa  1 , Shailendra Katwal  2
Affiliations

Association of detrusor wall thickness (DWT) with lower urinary tract symptom severity in benign prostatic hyperplasia: a cross-sectional study

Kishor Bhattarai et al. Ann Med Surg (Lond). .

Abstract

Background and objective: Benign prostatic hyperplasia manifests as lower urinary tract symptoms (LUTS) and prostate gland enlargement, leading to bladder outlet obstruction with consequent structural and functional impacts on the bladder. Urodynamic studies are resource-intensive and invasive. Detrusor wall thickness (DWT) assessment offers a cost-effective, reproducible alternative for evaluating LUTS severity in males with bladder outlet obstruction, utilizing ultrasonographic examination.

Methods: This prospective cross-sectional study, conducted at a tertiary care center from May 2023 to January 2024, included 171 patients with LUTS who underwent transabdominal ultrasound for DWT measurements. LUTS severity, assessed using International Prostate Symptom Scores (IPSS) classified participants into mild and moderate-to-severe symptom groups. Pearson's correlation coefficient assessed the association between DWT and IPSS, and an independent sample t-test compared means, using a significance level of 5% (P-value ≤0.05).

Results: This study involved participants aged 65.01±11.55 years with an IPSS score ranging from 1 to 35, with a mean for mild and moderate-to-severe symptom groups were 4±2.12 and 15.93±6.74, respectively. DWT mean of 1.64±0.38 mm for mild, and 2.4±0.43 mm for moderate to severe symptoms. Pearson's correlation (r=0.697, n=171, P<0.001) indicated a strong DWT-LUTS correlation and a significant DWT mean difference between mild and moderate-to-severe symptom groups was found via an independent t-test (P<0.001, 95% CI: -0.8970 to -0.6414).

Conclusion: The study establishes the value of transabdominal ultrasound-detected DWT as a cost-effective, noninvasive, and reproducible tool for assessing LUTS severity in males with benign prostatic hyperplasia.

Keywords: benign prostatic hyperplasia; bladder outlet obstruction; detrusor wall thickness; international prostate symptom score; lower urinary tract symptoms; transabdominal ultrasound.

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Conflict of interest statement

All the authors declare that they have no competing interest.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Figures

Figure 1
Figure 1
Chart for IPSS score.
Figure 2
Figure 2
USG image of anterior urinary bladder wall showing measurement of detrusor wall thickness (measured in between the echogenic mucosal and adventitial layers).
Figure 3
Figure 3
STROCSS flow diagram illustrating the participant flow of the Benign Prostatic Hyperplasia.
Figure 4
Figure 4
Scatter Plot of Detrusor Wall Thickness (DWT) and Lower Urinary Tract Symptom Severity (LUTS).
See this image and copyright information in PMC

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