TY - JOUR

T1 - Postoperativ urinretention. Klinisk vurdering versus ultralydskanning

AU - Pedersen, Lars Møller

AU - Mantoni, Teit

AU - Lynggaard, Margrethe Duch

AU - Schousboe, Birgitte M B

AU - Lauritzen, Jes Bruun

AU - Pedersen, Bente Dyrlund

AU - Jørgensen, Henrik Løvendahl

PY - 2007/2/12

Y1 - 2007/2/12

N2 - INTRODUCTION: 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.MATERIAL AND 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.CONCLUSION: 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.

AB - INTRODUCTION: 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.MATERIAL AND 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.CONCLUSION: 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.

KW - Clinical Competence

KW - False Negative Reactions

KW - False Positive Reactions

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Observer Variation

KW - Organ Size

KW - Postoperative Complications

KW - Predictive Value of Tests

KW - Urinary Bladder

KW - Urinary Retention

KW - Comparative Study

KW - English Abstract

KW - Journal Article

M3 - Tidsskriftartikel

C2 - 17311756

VL - 169

SP - 605

EP - 608

JO - Ugeskrift for Laeger

JF - Ugeskrift for Laeger

SN - 0041-5782

IS - 7

ER -