World J Urol (2009) 27:747–753 BVM 6500 device could not deliver a valid measurement in up to 14% of patients, thicker anterior bladder walls could not be measured correctly, and the variation of repeated measurements was higher than with conventional ultra- sound. Even though the performance of BVM 6500 device is encouraging, automatic BWT measurements cannot replace hand measurements with conventional ultrasound at this point of development. Acknowledgments C.M. thanks the Alexander S. Onassis Public BeneWt Foundation for a grant oVered to attend a clinical fellowship program. The enthusiastic collection of the measurement data and ultrasound images by Ms. Joyce Baard is gratefully acknowledged. ConXict of interest statement The authors declare that they have no conXict of interest. Open Access This article is distributed under the terms of the Cre- ative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. References 1. 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. doi:10.1016/S0022- 5347(01)63723-6 2. Hakenberg OW, Linne C, Mansek A, Wirth MP (2000) Bladder wall thickness in normal adults and men with lower urinary tract symptoms and benign prostatic enlargement. Neurourol Urodyn 19:585–593. doi:10.1002/1520-6777(2000)19:5<585::AID-NA U5>3.0.CO;2-U 3. Oelke M, Höfner K, Wiese B et al (2002) Increase in detrusor wall thickness indicates bladder outlet obstruction (BOO) in men. World J Urol 19:443–452 4. Kessler TM, Gerber R, Burckhard FC et al (2006) Ultrasound assessment of detrusor thickness in men—can it predict bladder outlet obstruction and replace pressure Xow study? J Urol 175:2170–2173. doi:10.1016/S0022-5347(06)00316-8 5. Oelke M, Höfner K, Jonas U et al (2007) Diagnostic accuracy of noninvasive tests to evaluate bladder outlet obstruction in men: detrusor wall thickness, uroXowmetry, postvoid residual urine, 753 and prostate volume. Eur Urol 52:827–834. doi:10.1016/j.eur- uro.2006.12.023 6. Khullar V, Salvatore S, Cardozo L et al (1994) A novel technique for measuring bladder wall thickness in women using transvaginal ultrasound. Ultrasound Obstet Gynecol 4:220–223. doi:10.1046/ j.1469-0705.1994.04030220.x 7. Khullar V, Cardozo LD, Salvatore S, Hill S (1996) Ultrasound: a noninvasive screening test for detrusor instability. Br J Obstet Gynaecol 103:904–908 8. Robinson D, Anders K, Cardozo L et al (2002) Can ultrasound replace ambulatory urodynamics when investigating women with irritative urinary symptoms? BJOG 109:145–148. doi:10.1111/ j.1471-0528.2002.01021.x 9. Cvitkovic-Kuzmic A, Brkljacic B, Ivankovic D, Grga A (2002) Ultrasound assessment of detrusor muscle thickness in children with non-neurogenic bladder/sphincter dysfunction. Eur Urol 41:214–219. doi:10.1016/S0302-2838(01)00023-9 10. Kaefer M, Barnewolt C, Retik AB, Peters CA (1997) The sono- graphic diagnosis of infravesical obstruction in children: evalua- tion of bladder wall thickness indexed to bladder Wlling. J Urol 157:989–991. doi:10.1016/S0022-5347(01)65127-9 11. Oelke M, Wijkstra H (2006) Ultrasound detrusor wall thickness measurements to diagnose bladder outlet obstruction in men. Uro- dinamica 16:343–352 12. Chalana V, Dudycha S, Yuk JT, McMorrow G (2005) Automatic measurement of ultrasound-estimated bladder weight (UEBW) from three-dimensional ultrasound. Rev Urol 7(Suppl 6):S22–S28 13. Schäfer W, Abrams P, Liao L et al (2002) Good urodynamic prac- tices: uroXowmetry, Wlling cystometry, and pressure-Xow studies. Neurourol Urodyn 21:261–274. doi:10.1002/nau.10066 14. Oelke M, Höfner K, Jonas U et al (2006) Ultrasound measurement of detrusor wall thickness in healthy adults. Neurourol Urodyn 25:308–317. doi:10.1002/nau.20242 15. Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1:307–310 16. Al-Housami F, Abrams P (2008) The use of ultrasound-estimated bladder weight in diagnosing bladder outlet obstruction and detru- sor overactivity in men. Eur Urol 7(Suppl):131. doi:10.1016/ S1569-9056(08)60241-9 (abstract) 17. Lee K, Lee Y, Lee SE et al (2008) The diagnostic eYcacy of three dimensional ultrasound estimated bladder weight corrected by body surface area as an alternative non-urodynamic parameter of bladder outlet obstruction. Neurourol Urodyn 27(Suppl):652–653 (abstract) 123