| Khullar 1994,97 prospective | 45 women with LUTS and attending UDS clinic; 19 detrusor instability; 20 stress incontinence | Transvaginal ultrasonography; residual volume < 20 ml; measurements perpendicular to the luminal surface at the thickest part of the trigone, at the dome and at the anterior wall. Operator performing BWT was blinded to UDS diagnosis | Video UDS in supine position with a fill rate of 100 ml/minute | Mean (SD) BWT: 6.7 mm (0.6 mm) in DO; 3.5 mm (0.6 mm) in SUI; difference between two conditions p < 0.001 on Mann–Whitney U-test |
| Khullar 1996;49 prospective | 184 women attending clinic owing to urinary symptoms, of whom 4 were excluded due to excessive PVR volume. Videocystourtherography UDS diagnosis: 43 detrusor instability; 52 SUI; 43 MUI; 34 normal UDS; 5 voiding difficulty; 3 sensory urgency) | Transvaginal ultrasonography; residual volume < 50 ml; measurements perpendicular to the luminal surface at the thickest part of the trigone, at the dome and at the anterior wall. Operator performing BWT was blinded to UDS diagnosis | Video UDS in supine position with a fill rate of 100 ml/minute; provocative tests used. BWT < 3.5 mm or with > 5 mm BWT but no DO also had ambulatory UDS (n = 42) | Median (IQR) BWT: 6.3 mm (5.3–7.7 mm) in DO; 3.9 mm (3.4–4.5 mm) in other groups; difference between two conditions p < 0.0001 on Mann–Whitney U-test. At BWT > 5 mm, 84% (75.8–89.7%) sensitivity; 89% (78.8–96.11%) specificity |
| Robinson 2002;52 prospective | 128 women with OAB with normal or equivocal UDS referred for ambulatory UDS (21 detrusor instability; 43 stress incontinence; 26 mixed incontinence; 37 normal; 1 other) | Transvaginal ultrasonography; residual volume < 50 ml; measurements perpendicular to the luminal surface at the thickest part of the trigone, at the dome and at the anterior wall. Operator performing BWT was blinded to UDS diagnosis | Ambulatory UDS; clinician performing UDS was blinded to BWT thickness | Mean (95% CI) BWT: 6.7 mm (6.0 mm to 7.4 mm) in DO; 5.1 mm (4.6 mm to 5.6 mm) in normal; 4.8 mm (4.4 mm to 5.3 mm) in USI; 5.8 mm (5.1 mm to 6.5 mm) in MUI; difference between four conditions. One-way ANOVA p = 0.0001 |
| Soligo 2002;58 prospective (conference abstract) | 161 women with urinary symptoms; 70 with OAB symptoms (46 stable; 24 unstable bladder); 91 without OAB symptoms (76 stable; 15 unstable bladder) | Does not indicate which type of ultrasonography; sites of BWT measurement not elaborated. Mean BWT was calculated | UDS performed in all women | Mean (95% CI) BWT: 5.0 mm (4.6 mm to 5.3 mm) OAB with DO; 3.6 mm (3.4 mm to 3.9 mm) OAB no DO; difference between two groups p < 0.001 one-way ANOVA. Combination BWT ≥ 5 mm and OAB symptoms, PPV 83.3%; NPV 83.2% |
| Yang 2002;59 retrospective with healthy controls | 1049 women with LUTS (190 detrusor instability; 764 stress incontinence; 95 hypersensitive bladder); additional 36 healthy controls | Transvaginal ultrasonography; measurements at dome and trigone; residual volume < 50 ml; cystourethrography | Uroflowmetry, filling and voiding phase cystometry, and a urethral pressure profile at both resting and Valsalva manoeuvre | Mean (SD) BWT: 5.8 mm ± 1.9 mm with DO; 6.0 mm ± 2.4 mm with SUI; 5.3 mm ± 1.9 mm hypersensitive bladder; 4.9 mm ± 2.1 mm controls. Pairwise comparisons adjusted for multiple testing, all significant (p < 0.05) except DO vs. SUI |
| Yang 2003;53 retrospective | 492 women with LUTS with normal urinalysis findings, negative urine culture results, or both. (UDS diagnosis: 38 DO; 248 SVI; 39 MUI; 35 hypersensitive bladder; 42 voiding difficulties; 90 normal UDS) | Transvaginal ultrasonography; measurement at dome and trigone; residual volume < 50 ml; cystourethrography | UDS at a filling rate of 80 ml/minute with patient sitting upright in a birthing chair | BWT measurements only reported in a figure |
| Chan 2005;114 prospective (conference abstract) | 86 women with VD; 22 DO; 22 sensory urgency; 42 normal | Transabdominal ultrasonography; volume 200 ml; measurement of anterior wall | No details of UDS given | Mean BWT: 1.7 mm in DO; 1.6 mm in sensory urgency; 1.7 mm in normal. No significant difference p = 0.18 |
| Parsons 2005;115 prospective with healthy controls (conference abstract) | 250 women. 194 women with troublesome urinary tract symptoms (31 DO; 33 normal OAB; 26 withdrew; 104 not mentioned);61 asymptomatic controls | Transvaginal ultrasonography; residual volume < 50 ml; measurements of the trigone, at the dome and at the anterior wall | Video UDS in all women | Mean BWT: 4.862 mm in DO; 4.085 mm in normal OAB; 3.92 mm in controls; t-test DO vs. normal OAB p = 0.007; t-test DO vs. control p = 0.007 |
| Minardi 2007;50 prospective with healthy controls | 80 women, including 66 referals for meantinence and 14 healthy controls. UDS diagnosis of symptomatic women: (36 SUI; 30 urgency incontinence) | Translabial or introital ultrasonography; no mention of residual volume; measurement of DWT at bladder dome; performed without knowledge of UDS results but by same assessor | UDS using Duet MultiP (Medtronic, Minneapolis, MN, USA) according to International Continence Society criteria | Mean (unstated measure of variation) DWT: 7.1 mm (1.6 mm) in urgency incontinence; 4.1 mm (1.1 mm) in stress incontinence; 3.9 mm (1.9 mm) in controls. ANOVA for differences between three groups p = 0.019 |
| Blatt 2008;116 prospective | 180 patients with non-neurogenic VD including 107 women (34 had DO; 39 had BOO; 38 had increased bladder sensation; 69 normal) | Transabdominal BWT measurements; 200 ml filling; measurements of the anterior bladder wall, 1 cm apart in the midline | Video UDS in all patients included uroflowmetry, filling cystometry at the rate of 50 ml per minute and pressure flow measurements | Mean (unstated measure of variation) BWT: 2.0 mm (0.53 mm) normal; 2.1 mm (0.47 mm) BOO; 1.9 mm (0.43 mm) DO; 1.8 mm (0.48 mm) increased bladder sensation. No significant difference was found between the groups (ANOVA p = 0.064) |
| Lekskulchai 2008;51 retrospective | 686 women attending a tertiary UDS service; four different UDS diagnoses were made, more than one diagnosis being made in several women. 184 DO; 135 sensory urgency. Number not stated for stress incontinence; number not stated for VD | Translabial ultrasonography; detrusor thickness measured at the bladder dome. Mean of three separate measurements was taken; measurements after voiding | Multichannel UDS | Mean (SD) DWT: 4.7 mm (1.9 mm) for DO; 4.1 mm (1.6 mm) for not DO; t-test p < 0.001. For 5 mm cut-off point, sensitivity 37%; specificity 79%; PPV 40%; NPV 70%; AUC 0.606 (95% CI 0.56 to 0.65) |
| Kuo 2009;56 prospective with healthy controls | 92 women in total. 28 OAB (dry) 25 OAB (wet) 28 normal controls and 11 controls with renal stones, lower back pain, inguinal hernia and/or turbid urine complaints. On video UDS of the women with OAB and normal controls, 22 had DO, 32 had hypersensitive bladder and 27 had a normal UDS | Transvaginal DWT scan on empty bladder and transabdominal DWT at bladder capacity. After uroflowmetry, transvaginal DWT was measured at bladder neck, bladder base, anterior and posterior wall. Transabdominal DWT was measured on anterior wall at three sites and an average obtained | All women underwent video UDS | Transvaginal DWT: no significant difference at the bladder neck, anterior wall, posterior wall and bladder base among women with between normal, hypersensitive bladder and DO. Transabdominal DWT was greater in DO group at maximum capacity. A transabdominal DWT of 0.75 mm at bladder capacity had: sensitivity 73%; specificity 67%; AUC of 0.776 (95% CI 0.643 to 0.909) by natural filling |
| Panayi 2010;72 prospective (conference abstract) | 182 women reporting symptoms; numbers per UDS diagnosis group are not given | Transvaginal ultrasonography; residual volume < 50 ml; measurements of the trigone, at the dome and at the anterior wall; clinician measuring BWT was blinded to UDS | UDS were performed in all women | Results are not presented grouped by the UDS diagnoses but by the presenting symptoms |
| Serati 2010;113 prospective | 247 women who attended the urogynaecology unit between 2005 and 2008. Diagnosis following UDS: 66 UDS SUI; 72 MUI; 75 isolated DO; 34 normal | Transvaginal ultrasonography; residual volume < 50 ml; measurements of the trigone, at the dome and at the anterior wall; clinician measuring BWT was blinded to UDS | UDS in all women | Mean (SD) BWT: 5.22 mm (1.17 mm) DO; 4.09 mm (0.86 mm) SUI; 4.73 mm (1.27 mm) MUI; 4.19 mm (1.14 mm) normal. At a cut-off point of 5 mm BWT: 50.34% sensitivity; 85.0% specificity; AUC 0.704 (95% CI 0.64 to 0.77) |
| Chung 2011;28 prospective with healthy controls | 122 women presenting with LUTS (83 from clinics with wet or dry OAB, 39 normal controls); by UDS: 28 normal; 30 increased bladder sensation; 30 DO. In addition, 39 untested by UDS presumed to be normal controls | Transabdominal DWT; measured with full bladder | 88 of 122 women underwent video UDS | Mean (SD) DWT: 0.95 mm (0.42 mm) in DO; 0.85 mm (0.31 mm) in increased bladder sensation; 0.85 mm (0.31 mm) in normal. No significant difference of DWT (no test result presented) |
| Kuhn 2011;54 prospective | 122 women with lower urinary symptoms; MUI was excluded (59 had SUI; 40 had DO; 24 had obstruction) | Transvaginal BWT; residual volume < 50 ml; technique not described.; clinician measuring BWT was blinded to UDS | UDS performed in all women in sitting position | Mean BWT (variance measure not stated): 3.78 mm (0.39 mm) in SUI; 4.97 mm (0.63 mm) in DO; 6.01 mm (0.73 mm) with obstruction; (p < 0.0001). AUC calculated was 0.87 mm (95% CI 0.78 mm to 0.97 mm; p < 0.0001). At a cut-off point of 4.4 mm to diagnose overactive or obstructive incontinence; 90.6% sensitivity; 96.6% specificity |
| Ibrahim 2011;55 prospective case–control study (conference abstract) | 60 women (30 cases who had detrusor instability; 30 controls without LUTS) | Transvaginal BWT; measurements of trigone, dome and anterior wall; clinician measuring BWT was blinded to UDS result | UDS undertaken in the 30 cases only | Mean (variance measure not stated) BWT: 5.00 mm (1.09 mm) in DO; 4.17 mm (0.91 mm) in controls. At a cut-off point of 5 mm; 53.3% sensitivity; 86.7% specificity |
| Ozturk 2011;57 prospective with healthy control (conference abstract) | 82 women from outpatient clinic (39 with DO; 43 with SUI), 31 controls | Transabdominal BWT; 200 ml volume; measurements of anterior wall, right and left lateral wall | UDS | Mean BWT not presented: at a cut-off point of 4.88 mm; 87.1% sensitivity; 60.8% specificity |
| Abou-Gamrah 2014;117 prospective | 100 women with urinary symptoms, mixed incontinence was excluded (50 with detrusor instability; 50 with stress incontinence) | Transvaginal ultrasonography; residual volume < 50 ml; measurements of the trigone, at the dome and at the anterior wall; measurement blind to UDS | UDS | Mean BWT not presented: at a cut-off point of 4.78 mm; 90% sensitivity; 78% specificity; AUC 0.905 |
| Otsuki 2014;118 prospective with continent controls | 91 women [30 stress incontinence; 30 DO; 31 continent (other gynaecological conditions)] | Transvaginal ultrasonography; residual volume < 50 ml; measurements of the trigone, at the dome and at the anterior wall; measurement blind to UDS | UDS | – |
| Silva 2014;119 prospective | 213 men and 59 women with neurogenic LUTS due to spinal injury (153 with DO or detrusor sphincter dyssynergia; 119 without detrusor sphincter dyssynergia) | Suprapubic ultrasonography; full bladder; single measurement of anterior bladder wall | Multichannel UDS in supine position | Mean (SD) BWT: 4.2 mm (1.3 mm) in NDO/DSD; 3.6 mm (1.2 mm) in not DSD. Difference between two conditions: p < 0.001 t-test; AUC 0.624 (95% CI 0.530 to 0.718) |
