Incidence of urinary retention and relations between patient's complaint, physical examination, and bladder ultrasound

Abstract

Objective To describe the frequency of urinary complaints, bladder globe, and need for bladder relief catheterization according to ultrasound; to investigate the relationship between the urinary volume estimated by ultrasound and the one drained in catheterization; and to describe the relationship of patient's complaints and detection of bladder globe with the diagnosis of urinary retention. Method A cross-sectional study with clinical patients with suspected urinary retention in a tertiary hospital, conducted from February to September 2018. Urinary volume ≥500 mL in ultrasound was considered urinary retention. Results Two hundred and five evaluations were performed in 44 patients. Urinary retention was detected by ultrasound in 33.2% of the evaluations. There was a strong correlation between ultrasound and bladder catheterization. There was a higher frequency of identification of bladder globe in urinary volumes ≥300 mL. Conclusion The incidence of urinary retention was higher when ultrasound was used for the diagnosis, when compared to patient's complaint and physical examination. Ultrasound showed to be accurate in establishing urinary volume.

Ultrassonografia à beira do leito para localização da sonda nasoenteral: concordância entre enfermeiro e médico

“…Em outra revisão sistemática, na qual 545 pacientes foram incluídos, a US para avaliação de posicionamento da sonda enteral foi empregada, principalmente, na UTI. A janela utilizada também foi epigástrica; identificou-sesensibilidade Suporte de oxigênio por óculos nasal 5 (16,7) Ar ambiente 2 (6,7)…”

“…A ultrassonografia tem se mostrado confiável no apoio à decisão diagnóstica e como guia de procedimentos. Nos últimos anos, esta tecnologia vem sendo incorporada a procedimentos realizados por enfermeiros, tais como punção venosa e arterial, avaliação de posicionamento de dispositivos (como cateteres urinários), avaliação da pele e avaliação de volume urinário (6,7) .…”

A 66-Year-Old Woman with Achondroplasia and Quadriparesis with an Ovarian Cyst Erroneously Diagnosed as Urinary Retention by an Automated Bladder Scan

“…The methodology of examining a distended bladder requires clinical skills that should be thoroughly taught to junior staff, who often fail to detect a moderately enlarged bladder [ 31 ]. In that respect, a bladder globe suggesting urinary retention was correctly detected by nurses in 34.8% of hospitalized patients with a determined bladder volume of 300–499 ml, while the ability to detect a distended bladder increased to 62.5% with bladder volumes >500 ml [ 32 ]. Point-of-care ultrasound should be used as an adjunctive measure to physical examination (if a specific diagnosis is not made).…”

Vantagens da ultrassonografia de bexiga na mensuração do volume urinário em pacientes críticos: revisão integrativa [Advantages of bladder ultrasound in measuring urine volume in critically ill patients: an integrative review] [Ventajas de la ecografía vesical en la medición del volumen urinario en pacientes críticos: revisión integradora]

“…It is essential to recognize that the US diagnosis performed by nurses involves several aspects such as professional experience, ability to perform the physical examination and, mainly, proper use of additional resources such as US 27 . Associating the use of technology during the physical examination to apply the Nursing diagnosis adds value to the nurses' assistance during conduction of the Nursing process 13,14,27 .…”

“…The studies pointed out the following as the main advantages of using bladder US in adult and aged critically ill patients: efficiency in measuring urinary volume 24,25,27 ; reduction in unnecessary use of IUCs 24,26,27 , decreased risk of urinary tract infection 24,25 , early detection of urinary retention 1,24 , cost reduction with unnecessary urinary catheterization 26 and diagnosis of IUC occlusion 24 .…”