The DWT at an emptied bladder was 4.73 ± 0.97 mm at anterior wall, 3.83 ± 1.06 mm at posterior wall, 4.67 ± 1.12 mm at bladder base and 9.10 ± 2.11 mm at the bladder neck.87 When we measured the DWT of the same group of patients from

lower abdomen using an 8 MHz trans-abdominal sonographic probe (8C, GE, model LOGIQ P5/A5), the DWT was 0.926 ± 0.287 mm at a bladder volume of 250 mL, 0.739 ± 0.232 at the bladder capacity, and 0.925 ± 0.257 mm after the bladder capacity was corrected to 250 mL. Putting these data together, it is clear that DWT changes with bladder volume and varies greatly when measuring through different scanning route. Therefore, it is necessary to standardize the technique and scanning frequency in measurement of DWT if we try to compare Ibrutinib NVP-BKM120 mouse DWT between different bladder disorder subgroups or performing a longitudinal study for DWT as biomarker of assessing OAB. The differences in the values of DWT obtained in various previous studies may have been caused by the use of different ultrasound probes with different frequency as well as to differences in the resolution of images. Review of previous reports found that studies using a higher frequency probe (7.5 MHz) reported a DWT of around 1–2 mm,80,81,83 whereas those using a low-frequency probe (2–5 MHz) reported a greater DWT of around 4–5 mm.77,82,88,89

In our previous studies, we used an 8 MHz high-frequency probe to measure the DWT either by TAU or TVU.85,86 Because the resolution power was able to differentiate the detrusor wall Org 27569 from the posterior rectus fascia, the measured DWT tended to be much less than would have been obtained using a 2–5 MHz low-frequency probe. Careful identification of the true bladder wall and accurate placement of cursors to measure the landmarks of DWT require experience. TVU assessment of mean BWT has been postulated to be a sensitive screening tool to detect DO in women with equivocal laboratory urodynamics. In women who have no evidence

of genuine SUI on laboratory studies, a cut-off of 6 mm of BWT by TVU has been highly suggested of having DO.89 Serati M et al. compared the ultrasound measurement of BWT in women with different urodynamic diagnosis and to correlate BWT to the different urodynamic findings of DO.90 They found that women with DO had a significantly higher BWT value. The measured BWT was 5.22 ± 1.17 mm in DO, 4.09 ± 0.86 mm in USI, 4.73 ± 1.27 mm in mixed incontinence, and 4.19 ± 1.14 mm in normal urodynamics. A cut-off of 6.5 mm for BWT had a positive predictive value of 100% for all DO. Although the ultrasound BWT showed a highly significant association with DO, data show a high level of overlap and it is only reliable in women with DO with a BWT cut-off value of >6.5 mm. The authors concluded that TVU-BWT cannot currently replace urodynamic testing.