[Postoperative urinary retention. Clinical assessment versus ultrasound examination].
BACKGROUND
Postoperative urinary retention can cause serious complications. An ultrasound bladderscanner has been shown to be useful in distinguishing between patients who need catheterisation and patients who do not. We wished to investigate if clinical assessment including inspection, percussion and palpation of the bladder is of any use in this perspective. In this study we compare clinical findings with ultrasound examinations.


METHODS
Two trained doctors each investigated 25 postoperative patients clinically immediately after ultrasound examination in the recovery room. Ultrasound examination was carried out by trained nurses using BladderScan BVI 3000. Assessed and measured volumes as well as patient height, weight, asa-class and sex were registered.


RESULTS
We found a high negative predictive value of 92% for a cut-off limit of 500 ml. The corresponding positive predictive value was a modest 38%. This tendency was seen for cut-off-limits exceeding 300 ml.


CONCLUSIONS
Clinical assessment of bladder size might be useful in terms of ruling out a big volume postoperatively. Because of the low positive predictive value, we recommend verifying urinary retention judged by clinical assessment with ultrasound examination before catheterisation. Also, one has to remember that urinary retention occurs with different volumes in different patients.
Pedersen
Lars Møller
LM
Bispebjerg Hospital, Anaestesiologisk Afdeling. larsmoellerp@yahoo.dk
Mantoni
Teit
T
Lynggaard
Margrethe Duch
MD
Schousboe
Birgitte M B
BM
Lauritzen
Jes Bruun
JB
Pedersen
Bente Dyrlund
BD
Jørgensen
Henrik Løvendahl
HL
D002983:Clinical Competence; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D009929:Organ Size; D011183:Postoperative Complications / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology*; D011237:Predictive Value of Tests; D014463:Ultrasonography; D001743:Urinary Bladder / Q000000981:diagnostic imaging; D016055:Urinary Retention / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology*