Three-dimensional bladder ultrasonography with the BladderScan1 overestimates post void residual one week after delive

Abstract

Three-dimensional bladder ultrasonography with the BladderScan1 overestimates post void residual one week after delivery Simone Salimans, Jolien Govaerts, Natasja de Jong, Jeroen van Bavel, Leonie Speksnijder* Amphia Hospital, Department of Obstetrics and Gynecology, Breda, the Netherlands A R T I C L E I N F O Article history: Received 4 November 2018 Received in revised form 1 March 2019 Accepted 16 April 2019 Available online 14 May 2019 Keywords: Postpartum period Urinary retention Ultrasonography Clean intermittent catheterization Voiding dysfunction A B S T R A C T Objective: Postpartum urinary retention is a frequent complication after childbirth. It is usually a temporary condition. However, unrecognised urinary retention can lead to considerable morbidity due to bladder over distention, detrusor atony and long term voiding dysfunction. In our clinic we noticed an overestimation of post void residual measured with the BladderScan1 in comparison with catheterization in women one week after delivery. Study design: We included 25 women in this prospective pilot study. These women had a urinary retention over 1000 ml within 4–5 h postpartum. Conform our local protocol, an indwelling catheter was inserted for one week. After removal of the indwelling catheter, a micturition trial was conducted. The post void residual was first measured with BladderScan1 (BVI 3000), directly followed by clean intermittent catheterization which is the golden standard at this moment. Results: There was a significant mean difference in post void residual measurements with the BladderScan1 and catheterization of 312 ml (95% CI 220–404 ml) (p < 0.001). According to our post void residual definition of 200 ml, the sensitivity and specificity of the BladderScan1 was respectively 100% and 17.6%. The positive predictive value was 36%. Conclusion: The BladderScan1 (BVI 3000) is a non-reliable instrument to measure post void residual one week postpartum. For now clean intermittent catherization remains the golden standard.