Lertbunnaphong Tripop, Inthasorn Perapong, Boriboonhirunsarn Dittakarn, Chuchotirot Monsak, Russameecharoen Kusol, Phattanachindakun Buraya
Department of Obstetrics and Gynecology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
J Med Assoc Thai. 2006 Oct;89 Suppl 4:S152-7.
To evaluate the correlation between assessment of postvoid residual urine by transabdominal ultrasound and catheterization in patients after radical or transvaginal hysterectomy.
A cross-sectional study was conducted and 46 patients were enrolled after they had radical and transvaginal hysterectomy. After surgery, urinary catheter was indwelled. After catheter removal and the 3rd private voiding, the patients were sent for transabdominal ultrasound assessment of PVR at the Division of Maternal-Fetal Medicine. Complete drainage of bladder with standard catheterization was then performed and catheterized urine volume was recorded. PVR was calculated from previously published equation and compared with actual PVR from catheterization.
Mean age of the patients was 55.9 years. The most common diagnoses were procidentia uteri (23.9%), Carcinoma of cervix stage 1b1 (23.9%), and prolapsed uteri grade 2 (21.7%). Radical hysterectomy with pelvic node dissection and vaginal hysterectomy with anterior colporhaphy and posterior colpoperiniorhaphy was performed each in 50% of cases. Mean duration of urinary catheter indwelling was 7.17 days for those underwent radical hysterectomy and 5 days for vaginal hysterectomy. The calculated PVR was significantly correlated with catheterized urine volume with correlation coefficient 0.93 (p < 0.001). If the usual cutoff of PVR > 100 ml was used to determine the necessity of re-indwelling catheter, among those with calculated PVR from ultrasound measurement < 100 ml, still 30% actually had actual PVR of > 100 ml. Among those with calculated PVR from ultrasound measurement >100 ml, all actually had actual PVR of > 100 ml.
PVR estimation by ultrasound significantly correlated with actual PVR. This could reduce the process of repeat catheterization and give more comfort to the patients when the PVR is > 100 ml.
评估经腹超声评估根治性或经阴道子宫切除术后患者残余尿量与导尿法之间的相关性。
进行一项横断面研究，46例接受根治性和经阴道子宫切除术的患者入组。术后留置尿管。拔除尿管并第3次自主排尿后，患者被送至母胎医学科行经腹超声评估残余尿量（PVR）。然后进行标准导尿以完全排空膀胱，并记录导尿量。根据先前发表的公式计算PVR，并与导尿法测得的实际PVR进行比较。
患者的平均年龄为55.9岁。最常见的诊断为子宫脱垂（23.9%）、1b1期宫颈癌（23.9%）和2度子宫脱垂（21.7%）。50%的病例分别进行了根治性子宫切除术加盆腔淋巴结清扫术以及经阴道子宫切除术加阴道前壁修补术和阴道后壁修补术。接受根治性子宫切除术的患者平均尿管留置时间为7.17天，接受经阴道子宫切除术的患者为5天。计算得出的PVR与导尿量显著相关，相关系数为0.93（p<0.001）。如果采用PVR>100 ml这一常用临界值来确定是否需要重新留置尿管，在超声测量计算得出的PVR<100 ml的患者中，仍有30%的患者实际PVR>100 ml。在超声测量计算得出的PVR>100 ml的患者中，所有患者实际PVR均>100 ml。
超声估计PVR与实际PVR显著相关。当PVR>100 ml时，这可以减少重复导尿的过程，给患者带来更多舒适感。
