title: The significance of detrusor wall thickness as a prognostic factor in pediatric bladder outlet obstruction.
abstract: OBJECTIVE
  The purpose of this study is to determine detrusor thickness as a prognostic factor in posterior urethral valves.
  
  
  METHODS
  The medical information of 41 patients diagnosed with posterior urethral valves at our institute was retrospectively reviewed. The serum creatinine level after bladder decompression, results of ultrasonography, and voiding cystourethrography were compared between groups divided according to the final bladder and renal function. Detrusor thickness was measured using Müller's method.
  
  
  RESULTS
  The median detrusor thickness was 1.3 mm (0.4-2.5 mm). After median 45.6 months (7.2-96.0 months) of follow-up, impaired bladder function (IBF) was observed in 14 patients. In multivariate analysis, detrusor thickness greater than 1.3 mm (odds ratio, 32.6; 95% confidence interval, 3.1-340.6; P = .004) was the only independent risk factor for later IBF. Final renal function impairment developed in 24 patients (58.5%), and 3 patients (7.3%) were diagnosed with end-stage renal disease after median 66.0 months (32.4-133.2 months) of follow-up period. On multivariate analysis, age-specific elevated serum creatinine level at presentation (odds ratio, 11.1; 95% confidence interval, 1.1-112.5; P = .042) was an independent risk factor.
  
  
  CONCLUSIONS
  Detrusor thickness more than 1.3 mm on ultrasonography was an independent prognostic factor for later IBF.
authors.affiliation: Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul 120-752, Korea.
authors.forename: Yong Seung
authors.initials: YS
authors.lastname: Lee
authors.forename: Hyun Jin
authors.initials: HJ
authors.lastname: Jung
authors.forename: Young Jae
authors.initials: YJ
authors.lastname: Im
authors.forename: Chang Hee
authors.initials: CH
authors.lastname: Hong
authors.forename: Sang Won
authors.initials: SW
authors.lastname: Han
mesh_terms: D015415:Biomarkers / Q000097:blood; D003404:Creatinine / Q000097:blood; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D016015:Logistic Models; D015999:Multivariate Analysis; D011379:Prognosis; D012372:ROC Curve; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D001743:Urinary Bladder / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D001748:Urinary Bladder Neck Obstruction / Q000097:blood / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy
chemical_list: D015415:Biomarkers; D003404:Creatinine