Measurement of Bladder Mass Using Ultrasonography: A New Tool for Measuring Bladder Outlet Obstruction

INTRODUCTION Measurement of Bladder Mass Using Ultrasonography: A New Tool for Measuring Bladder Outlet Obstruction Victor W. Nitti, MD Department of Urology, New York University School of Medicine, New York, NY [Rev Urol. 2005;7(suppl 6):S1-S2] © 2005 MedReviews, LLC ladder outlet obstruction (BOO) is commonly associated with lower urinary tract symptoms (LUTS). Often, the treatment of LUTS requires treatment of BOO. As such, an accurate diagnosis of BOO is required. The diagnosis of BOO can be implied or presumed based on non-invasive studies such as uroflow and post void residual studies, but a precise diagnosis requires more invasive urodynamic testing. Recently new tools have been described that may allow for an accurate non-invasive diagnosis of BOO. These include noninvasive pressure-flow determination and the measurement of bladder mass by ultrasonography. To investigate these new developments and tools, a roundtable of experts in urodynamic testing and bladder function was convened in New York City on B VOL. 7 SUPPL. 6 2005 REVIEWS IN UROLOGY S1 Introduction continued December 15, 2004. These national and international thought leaders came together to discuss the potential role of measuring bladder diameter as a simple and non-invasive way to test the magnitude of bladder outlet obstruction. The primary focus of the roundtable was to investigate and evaluate the efficacy of measuring bladder width using ultrasonography. The presentations and discussions form the basis of this supplement to Reviews in Urology. The supplement begins with a comprehensive discussion on the etiology S2 VOL. 7 SUPPL. 6 2005 and evaluation of BOO in men and women by Dr. Roger Dmochowski. This is followed by my review of urodynamics and pressure-flow studies, the current gold standard for the diagnosis of BOO. Included here are the most recent data regarding the use of non-invasive measures of pressure and flow. The remaining articles introduce the concept of ultrasound–estimated bladder weight (UEBW) as a diagnostic tool to measure BOO. In the first manuscript, Dr. Vikram Chalana and colleagues describe the development of the REVIEWS IN UROLOGY approach to measure UEBW. This has led to the introduction of a hand held device that performs three dimensional imaging of the bladder. The 2 manuscripts that follow describe the use of UEBW in clinical practice. Dr. Christopher Kelly highlights the early experience comparing pressure flow studies with UEBW and Dr. Andrea Tubaro and associates expand on this and also look at the change in UEBW after treatment of BOO. We hope you enjoy this supplement and find the information contained ■ herein informative.