3/26/2023 0 Comments Residual urineIf a patient is distressed, it is advisable to insert a urinary catheter regardless of volume. Some patients may be very distressed by a residual volume of urine of 300ml while others will have no problems with a residual volume of 700ml. Incorrect positioning of patient during the bladder ultrasound Other reasons for false readings include:īladder has an unusual shape (Coombes and Millard, 1994) Īltered position or shape of the bladder following surgery (such as hysterectomy) If fluid is still present following catheterisation an ovarian cyst may be suspected and an urgent referral should be made to a gynaecologist.įalse readings can be obtained with volumes over 1,000ml and under 100ml (Ouslander et al, 1994). If residual urine is found in a healthy woman with no underlying neurological condition, a catheter should be inserted to ensure the fluid observed is urine. Identifying bladder neck elevation and relaxation during a pelvic floor education programme Įvaluating the effect of anticholinergic medication on voiding function, particularly with patients who have bladder instability associated with a neurological condition. It is possible to see an inflated catheter balloon in the bladder using certain ultrasound machines Other uses include:Īssessment of catheter-related problems. Portable bladder ultrasound can also be used as part of continence assessment. Is the urinary retention having an effect on the patient’s health status? Assessing this will include a review of renal function. Is the urinary retention acute or chronic? This may influence how urgently interventions are required ĭoes the patient have symptoms that are linked to the voiding problem and associated urinary retention? These may include hesitancy, poor stream, intermittent stream, urgency and frequency and may have a direct effect on quality of life Is the voiding problem likely to be curable or incurable? If the patient has multiple sclerosis, the voiding problem is incurable but, in a male with an enlarged prostate, it may be curable Is there a diagnosed, undiagnosed or suspected cause for the residual urine? Is the volume of residual urine found on ultrasound significant? Under 100ml is insignificant, between 100ml and 500ml could be significant and over 500ml is very significant The health professional reviewing the results of a portable bladder ultrasound needs to consider: There are risks associated with using portable bladder ultrasound results alone to decide on interventions such as intermittent self-catheterisation.Ī residual urine status model can provide a framework for the healthcare professional to rationalise clinical decisions, care planning and interventions (Box 1). Portable bladder ultrasound is a very low-risk activity compared with catheterisation to estimate a residual volume of urine in the bladder, although catheterisation remains the gold standard. Nurses need to consider the risk of any intervention they undertake (NMC, 2004). Detrusor failure may not be resolved even when the cause of the outflow problem has been removed, for example by a prostatectomy, and residual urine volume accompanied by symptoms of poor bladder emptying may occur after surgery. This results in the accumulation of toxic waste products in the bloodstream, which can cause sickness, skin irritation and confusion.ĭetrusor failure can occur when the bladder has been stretched to accommodate a residual volume of urine or it may occur due to the effort required by the bladder muscles to expel urine past an outflow obstruction. However, some patients may be asymptomatic but have serious complications.Ĭomplications of voiding problems include compromised renal function and renal failure caused by back pressure of urine in the bladder, which leads to dilation of the ureters and renal congestion (hydronephrosis). Patients may complain of voiding problems including hesitancy, intermittency, frequency and poor stream.
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