Ultrasound assessment of detrusor muscle thickness in children with non-neuropathic bladder/sphincter dysfunction.

OBJECTIVE: To measure detrusor muscle thickness in children with non-neuropathic bladder/sphincter dysfunction (NNBSD), and to evaluate the difference between children with various bladder dysfunctions and those with normal urodynamics.

MATERIALS AND METHODS: In 139 children the urodynamic study was performed, and the detrusor of the anterior bladder wall was measured using high-frequency ultrasonography (US). Children were categorized into five groups, according to urodynamic findings. Differences in detrusor thickness between groups were tested by one-way ANOVA with post hoc Scheffé test.

RESULTS: Forty-six children (33.1%) had normal urodynamics, and mean (+/-S.D.) detrusor thickness 1.3 +/- 0.5 mm (range 0.5-3.0). Fifty-two (37.4%) had urge syndrome, with detrusor thickness of 2 +/- 0.7 mm (1.0-3.6). Thirty-three (23.7%) had dysfunctional voiding, with detrusor thickness of 2.6 +/- 0.5 mm (1.5-3.6). Four (2.9%) had lazy bladder, with detrusor thickness of 0.9 +/- 0.1 mm (0.8-1.0), and four had anatomical infravesical obstruction, with detrusor thickness of 4.4 +/- 0.3 mm (4-4.6). The mean detrusor thickness in all children with NNBSD was 2.2 +/- 0.7 mm (range 0.8-3.6). Multiple comparisons showed significant difference between all groups, except between children with normal urodynamics and children with lazy bladder.

CONCLUSION: There is statistically significant difference in mean detrusor thickness between children with normal urodynamics and children with NNBSD. However, due to the overlap of measured values, it is not possible to determine the cut-off value that could be used to distinguish children with and without NNBSD.