title: Detrusor overactivity increases bladder wall thickness in male patients: A urodynamic multicenter cohort study.
abstract: OBJECTIVE
  To evaluate the role of Bladder wall thickness (BWT) as a predictor of Detrusor overactivity (DO) in patients with Lower urinary tract symptoms (LUTS)/Benign prostatic enlargement without Bladder Outlet Obstruction.
  
  
  METHODS
  From January 1996 to December 2000, each new patient, aged 45 years or older with LUTS, underwent standard diagnostic assessment, urodynamic studies (cystometry and pressure flow studies), and ultrasound measurements of the bladder wall thickness (BWT) in two centers. In order to exclude the possible effect of benign prostatic obstruction (BPO) on detrusor thickness, patients with a Schaefer class was ≥2 were excluded from the study. The area under the receiver operating characteristics curve (AUC) quantified the predictive accuracy (PA) of BWT for the diagnosis of DO.
  
  
  RESULTS
  Overall 195 patients were enrolled. DO was observed in 98/195 patients (50%). The BWT presented an AUC of 0.70; 95% CI: 0.62-0.77 for the diagnosis of DO. At the best cut-off value of 3.85 mm sensitivity was 73%; specificity was 59%; positive predictive value (64%, PPV). Negative predictive value (69%, NPV).
  
  
  CONCLUSIONS
  Our study firstly showed, how BWT in male patients may be a consequence of DO other than BPO. Our finding, if confirmed in further studies, could limit the accuracy of BWT in patients with DO and BPO.
authors: Department of Urology, Ospedale Sant'Andrea, Sapienza University of Rome, Rome, Italy.
authors: Cosimo
authors: C
authors: De Nunzio
authors: Department of Urology, Ospedale Sant'Andrea, Sapienza University of Rome, Rome, Italy.
authors: Fabrizio
authors: F
authors: Presicce
authors: Department of Urology, Ospedale Sant'Andrea, Sapienza University of Rome, Rome, Italy.
authors: Riccardo
authors: R
authors: Lombardo
authors: Department of Urology, London Clinic, London, United Kingdom.
authors: Simon
authors: S
authors: Carter
authors: Department of Surgical Sciences, University of L'Aquila, L'Aquila, Italy.
authors: Carlo
authors: C
authors: Vicentini
authors: Department of Urology, Ospedale Sant'Andrea, Sapienza University of Rome, Rome, Italy.
authors: Andrea
authors: A
authors: Tubaro
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009130:Muscle, Smooth / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011470:Prostatic Hyperplasia / Q000000981:diagnostic imaging / Q000503:physiopathology*; D014463:Ultrasonography; D053201:Urinary Bladder, Overactive / Q000000981:diagnostic imaging / Q000503:physiopathology*; D014563:Urodynamics / Q000502:physiology*
keywords: benign prostatic enlargement; benign prostatic obstruction; lower urinary tract symptoms