Comparison of BladderWall Thickening and Presence of Internal Echoes Within the Bladder for the Diagnosis of Cystitis in Infants

Background: Cystitis is very common in children and the diagnosis is usually made based on clinical findings with laboratory examinations including urinalysis and urine culture. Bladder wall thickening and presence of fine nodule shaped echoes within the bladder are the suggested sonographic findings of cystitis. Objectives: In this study we aimed to compare diagnostic value of bladder wall thickening and presence of fine nodule shaped echoes within the bladder and also perivesical fluid collection for cystitis in infants by correlating urinalysis results. Methods: Urinary tract ultrasound and urinalysis results of a total 1094 infants were retrospectively screened. Patients were classified as groups according to presence of internal echoes in bladder lumen and/or bladder wall thickening and/or perivesical fluid collection. Control group was constituted of the patients who had normal ultrasound results. Also three subgroups of group 2 (the patients with only bladder wall thkening, P2) were classified according to the size of the thickening. Comparison of pathological urinalysis rate of each group with control group was made with statistical analysis. Also subgroups of group 2 (P2) were compared with each other. Results: When compared with control group, all the groups except perivesical fluid group (P1), had statistically significantly higher pathological urinalysis rates (P < 0.05). The pathological urinalysis rates are highest in the thickened wall and echoes in the lumen and perivesical fluid group (P8) and in the thickened wall and echoes in the lumen without perivesical fluid group (P7) (60% and 54.5%, respectively). Also among subgroups of group 2, pathological urinalysis rate was highest in subgroup 3 in which the patients had most thickened bladder wall and the difference was found to be statistically significant (P < 0.005). Conclusions: We suggest that when thickened wall or echoes in the lumen or perivesical fluid collection accompany each other, pathological urinalysis rates increase. Also pathological urinalysis rates increase as the size of thickness of bladder wall increases.