From the Guidelines
Bladder scan results should be interpreted with caution, considering the patient's medical history, symptoms, and complete clinical picture, as a single reading may not accurately indicate pathology. When interpreting bladder scan results, it is essential to consider the post-void residual (PVR) volume, which can indicate incomplete bladder emptying if elevated. According to general guidelines, a PVR volume less than 50 mL is considered normal, while volumes greater than 100-200 mL may indicate incomplete bladder emptying 1.
Key Considerations for Interpretation
- Provide the healthcare provider with a complete medical history, current medications, and any urinary symptoms being experienced.
- Bladder scans use ultrasound technology to measure remaining urine after voiding, helping diagnose conditions like urinary obstruction, neurogenic bladder, or detrusor muscle dysfunction.
- Results must be considered alongside symptoms and medical history, as a single elevated reading may not necessarily indicate pathology.
Potential Treatment Options
- If urinary retention is diagnosed, treatment might include medications like tamsulosin 0.4 mg daily for men with prostatic obstruction, or bethanechol 10-50 mg three times daily to improve bladder contractility.
- Intermittent catheterization may be necessary in some cases.
- Proper hydration and timed voiding can also help manage mild retention. It is crucial to approach bladder scan results with a comprehensive understanding of the patient's clinical context, as recommended by guidelines from reputable organizations such as the American College of Physicians 1.
From the Research
Bladder Scan Results Interpretation
Bladder scan results are used to assess the amount of urine left in the bladder after voiding, known as post-void residual (PVR) volume. The interpretation of these results is crucial in diagnosing and managing urinary retention.
- A PVR volume greater than 300 mL measured on two separate occasions and persisting for at least six months is defined as chronic urinary retention by the American Urological Association 2.
- The measurement of PVR volume is an essential part of the initial evaluation of urinary retention, along with a detailed history and focused physical examination with neurologic evaluation 2.
- Bladder ultrasonography can be used to measure PVR volume and reduce the rate of bladder damage and urinary tract infections 3.
Causes of Urinary Retention
Urinary retention can be caused by various factors, including:
- Obstructive causes, such as benign prostatic hyperplasia, which accounts for 53% of cases in men 2.
- Infectious, inflammatory, iatrogenic, and neurologic causes can also affect urinary retention 2, 4.
- The etiology of acute urinary retention can be varied and multifactorial, and treatment aims to relieve the obstruction and mitigate the underlying cause of retention 4.
Management of Urinary Retention
The management of urinary retention involves:
- Assessment of urethral patency with prompt and complete bladder decompression by catheterization 2.
- Suprapubic catheters can improve patient comfort and decrease bacteriuria and the need for recatheterization in the short term 2.
- Further management is decided by determining the cause and chronicity of the urinary retention and can include initiation of alpha blockers with voiding trials 2.