The accuracy of clinical assessment of bladder volume.
OBJECTIVE
To determine the usefulness of physical examination in detecting elevated bladder volume.


METHODS
A blinded study of clinical examination by physicians to detect elevated bladder volumes compared with a criterion standard (ultrasonic bladder volume measurement).


METHODS
Outpatient department of a general hospital in New Zealand.


METHODS
Sixteen healthy adult volunteers (age range, 21-37 y; body mass index range, 22.9-37.2 kg/m(2)) and 8 qualified resident physicians with 2 to 6 years of clinical experience.


METHODS
Elevated bladder volumes were achieved by randomly allocating the volunteers to void or not to void before the clinical examination.


METHODS
Clinical examination of the abdomen by abdominal palpation and suprapubic percussion, compared with portable ultrasound findings, to determine whether a healthy adult has a full bladder.


RESULTS
For bladder volumes of 400 to 600 mL, physical examination to detect a full bladder was 81% sensitive (95% confidence interval [CI], 54-96), 50% specific (95% CI, 39-68), and 55% accurate (95% CI, 45-65). The likelihood ratio for a positive finding on physical examination was 1.62 (95% CI, 1.17-2.24).


CONCLUSIONS
Physical examination of the abdomen by relatively junior physicians is unreliable in detecting bladder volumes between 400 and 600 mL in healthy volunteers.
Weatherall
Mark
M
Department of Medicine, University of Otago Wellington School of Medicine, Wellington, New Zealand. markw@wnmeds.ac.nz
Harwood
Matire
M
D000328:Adult; D002983:Clinical Competence; D006801:Humans; D007396:Internship and Residency; D016013:Likelihood Functions; D010173:Palpation; D010808:Physical Examination / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D001743:Urinary Bladder / Q000033:anatomy & histology* / Q000000981:diagnostic imaging