SONOGRAPHIC ASSESSMENT OF POSTVOID RESIDUAL URINE VOLUMES: MATERIALS AND METHODS

Fifty-four consecutive patients with symptoms and clinical signs of prostatic gland enlargement had transabdominal ultrasonography at the Department of Radiology, University of llorin Teaching Hospital, llorin, between January and August 2001. Of these, two were excluded from the study, as bladder catheterization was impossible due to concomitant urethral stricture. Patients with in-dwelling bladder catheters due to acute urinary retention or neurological disorders were not included in the study. Also excluded were patients with which was immediately after voiding. With the subject lying supine, the transducer was positioned to view the maximum longitudinal section, usually at the midline. Maintaining the same contact point the transducer was rotated through 90 degrees and then angled up and down to find the largest transverse area. Two orthogonal diameters were then measured on each of these bladder sections. On the maximal longitudinal image, the maximum longitudinal (L) and anteroposterior diameters (Dl) were taken. On the maximal transverse image, the maximum transverse diameter (T) and height (Dt) were obtained (Figure 1). These measurements were recorded for both examinations. To minimize observer error at the stage of imaging, one sonologist acquired and measured all images using specific guidelines. To exclude prejudice, an assistant who had no knowledge of the ultrasound measurements catheterized each patient to assess the PVR volume under strict asepsis. This volume was regarded as the gold standard. Complete drainage of the bladder was ensured by suprapubic expression of the urinary bladder under ultrasonic guidance and cessation of urine flow from the catheter. Catheterized residual urine volume ranged between 26 and 801 ml (mean 220.76±194.40 ml), while the ultrasonographic estimates were between 33.2 and 772 ml (mean 220.51 ±190.46 ml).

Figure 1. Pelvic Sonograph Showing Measuring Calipers in Longitudinal and Transverse Images of the Urinary Bladder

All examinations were carried out with a Siemens Sonoline Sx scanner with a 3.5-MHz transducer. A measuring cylinder was used to determine the catheterized volume.
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Category: Health

Tags: prostate gland, ultrasonography, urine residue