Urinary bladder wall thickening

Last revised by Yuranga Weerakkody on 25 Jun 2023

Urinary bladder wall thickening is a common finding and its significance depends on whether the bladder is adequately distended.

Radiographic features


In both adults and children, the wall may be considered thickened on ultrasound if it measures 6:

  • >3 mm when distended (>25% expected volume*)

  • >5 mm when non-distended (<10% expected volume*)

* normal adult bladder volume is 300-400 mL 7


Bladder wall thickness varies with volume, ultrasound cut-offs may not be applicable 8.

Differential diagnosis

If the bladder is not distended, then it is difficult to exclude artifactual thickening from a collapsed bladder

If the bladder wall is adequately distended, then a differential may be developed based on whether the bladder is diffusely thickened or focally thickened:

Diffuse bladder wall thickening
Focal bladder wall thickening

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Cases and figures

  • Case 1: local invasion of sigmoid colon cancer
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  • Case 2: cystitis
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