PURPOSE: We investigated the correlations between ultrasonographic bladder wall 
thickness and urodynamic parameters, and estimated the diagnostic accuracy of 
bladder wall thickness for predicting unfavorable urodynamic patterns in 
children with myelodysplasia.
MATERIALS AND METHODS: A total of 57 children (median age 5.1 years) with 
myelodysplasia were enrolled in the study. All children underwent 
ultrasonography to measure bladder wall thickness. Videourodynamic evaluation 
was also performed within 3 months of ultrasound assessment. Bladder wall 
thickness was compared to urodynamic data. A urodynamic risk of upper urinary 
tract deterioration was defined as maximum detrusor pressure greater than 40 cm 
H(2)O during filling or at leakage, or sphincter dyssynergia during voiding.
RESULTS: Bladder wall thickness was significantly correlated to detrusor leak 
point pressure, maximum amplitude of detrusor overactivity and maximum detrusor 
pressure during storage phase. In 16 children who had unfavorable urodynamic 
risk patterns the mean bladder wall thickness was 3.9 +/- 1.0 mm, compared to 
2.4 +/- 0.7 mm in 41 patients with favorable urodynamic patterns. There was a 
significant difference between bladder wall thickness in children with and those 
without urodynamic risk factors (p <0.001). For a diagnosis of unfavorable 
urodynamic patterns bladder wall thickness greater than 3.3 mm had a positive 
predictive value of 85.7%, a negative predictive value of 90.7%, specificity of 
75.0% and sensitivity of 95.1%. Receiver operator characteristic analysis 
revealed that bladder wall thickness had a high predictive value for unfavorable 
urodynamic patterns, with an area under the curve of 0.908.
CONCLUSIONS: Ultrasonographic assessment of bladder wall thickness is a 
sensitive screening tool for the diagnosis of urodynamic risk factors for upper 
urinary tract deterioration in children with myelodysplasia.