Bladder wall thickness

A 53-year-old man with severe panc5rtopenia and splenomegaly and a history of pain during urination and hematuria for 2 years was found to have increased bladder wall thickness and massive splenomegaly, which was attributed to bladder cancer with splenic metastases [33 ]. He had been exposed to an unspecified cellulosic dye in his job and had a history of smoking and drinking whisky and raki daily for 25 years. 

For the evaluation of children with symptoms of nonneurogenic bladder-sphincter dysfunction by ultrasound, a careful examination of the urinary bladder has to be performed in particular. Not only structural abnormalities have to be searched for bladder wall thickness, bladder volume and residual urine volume after voiding have to be assessed. Similar as described before for the modified VCU technique, the bladder base and bladder neck respectively have to be observed carefully by ultrasound as well. A transient opening of the bladder neck together with uninhibitetd detrusor contractions with filling of the posterior urethra up to the con-... 

In 1997 Kaefer et al. published that the bladder thickness index (bladder wall thickness was indexed to innerwall diameter) is a sensitive sonographic predictor of infravesical obstruction application of this index could be a non-invasive screening tool for the patient with persistent nonneurogenic bladder-sphincter dysfunction. 

Pediatric radiologists performing ultrasound studies in children with clinical symptoms of nonneurogenic bladder-sphincter dysfunction and in enurectic children should not only evaluate for structural abnormalities, but should search for signs of unstable bladder (open bladder neck) and should measure residual volume after voiding and bladder wall thickness according to published standards (bladder wall thickness varies minimally with age. 

Kafer M, Barnewolt C, Retik AB et al (1997) The sonographic diagnosis of intravesical obstruction in children evaluation of bladder wall thickness indexed to bladder filling. JUrol 157 989-991... 

After the physical examination has been completed, ultrasonography should be performed. A realistic interpretation of an ultrasound examination is important since it provides only anatomic information dilatation of the urinary trart is not necessarily induced by obstruction, particularly in patients with prune belly syndrome. In addition to dilatation of the renal pelvis and the ureter, bladder filling and bladder wall thickness can be determined by ultrasound (Fig. 17.3). Bladder outlet obstruction is usually associated with... 

Manieri C, Carter SS, Romano G et al (1998) The diagnosis of bladder outlet obstruction in men by ultrasound measurement of bladder wall thickness. J Urol 159 761-765... 

While the bladder is opacified percutaneously, leakage into the prevesical space can occur. This should not interrupt the examination since it resolves spontaneously. The bladder appears thick-walled with marked sacculations and trabecula-tions. Diverticula maybe present. 

According to Leung et al. (2007) nomograms of total renal volume, urinary bladder volume index and bladder volume wall thickness index are described as useful indicators of bladder dysfunction in children with enuresis and urinary tract infection (Yeung et al. 2007). 

Bladder histology of fetuses with prune belly syndrome and no evidence of obstruction showed thin bladder walls with increased connective tissue. However, fetuses with posterior urethral valves or with prune belly syndrome and evidence of urinary tract obstruction had increased bladder muscle thickness (Popek et al. 1991). These results suggest that the phenotypic appearance of the prune belly syndrome may result from a mesenchymal defect, but urinary tract obstruction may contribute. Chest wall anomalies, gut malrotation, and orthopedic malformations are secondary to the abdominal wall defect or oligohydramnios. 

It is also possible that attenuated radiation from yttrium microspheres in liver metastases adjacent to the gallbladder also contribute to this complication however, this is thought less likely because it implies that radiation induced gastritis and colitis would occur more often [25]. When radiation induced cholecystitis occurs, a characteristic thick walled appearance of the gall bladder may be observed on cross-sectional images [13J. 

Fig. 10.19. Clear cell carcinoma. Parasagittal T2-weighted image shows a large, well-delineated cystic ovarian lesion cepha-lad of the bladder (B), which extends to the midlumbar region. At its anterior wall, broad-based protruding nodules (arrow) with a thickness of more than 2 cm are demonstrated, a typical finding of an ovarian malignancy. Courtesy of Dr. M.T. Cunha, Lisbon...

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