Department of Urology, Seoul National University College of Medicine, Seoul, Republic of Korea.
Department of Pediatric Urology, Seoul National University Children's Hospital, Seoul, Republic of Korea.
J Pediatr Urol. 2022 Jun;18(3):344-349. doi: 10.1016/j.jpurol.2022.02.001. Epub 2022 Feb 8.
The bladder scanner (BS), a portable ultrasound device specialized in bladder volume measurement, has been developed and applied to clinical assessment of postvoid residual urine, which is a requisite in evaluating patients with voiding dysfunction. However, experiences in the application of the BS to the pediatric population remain limited despite commonly encountered reluctance to catheterization. This prospective observational study aimed to evaluate the correlation and accuracy of the newly developed pediatric module of the BS (BioCon-900) in measuring bladder volume in children 0-6 years old.
This study included 29 patients scheduled to undergo preventive untethering for their spinal dysraphism. When they undergo cystometry for the confirmation of normal neurologic function, bladder volume was measured by BS when recorded volume infusion reached each quartile of the age-adjusted estimated bladder capacity (EBC). The difference (bias) between measured and infused volume was expressed as a percentage of EBC (%EBC). The correlation coefficient and the Bland-Altman plot were obtained to determine the discriminating power and accuracy, respectively. The acceptable limit was set as 30%EBC.
A strong correlation between the measured and infused volume (r = 0.95, P < 0.001) was found for the entire age range. This excellent correlation remained comparable between children less than three years and the older ones. Bladder volume tended to be overestimated, and the mean bias was 33 ± 22.3%EBC, and it became higher with increasing quartiles. The accuracy was acceptable in all ranges of measurement in the older group and first and second quartiles in the younger one.
We have first evaluated the potential use of BS in 0-3 years old children and compared the results with 4-6-year-old children in whom the accuracy of BS has been demonstrated. The strong point of our study was the inclusion of data spanning all quartiles of bladder volume. The use of infused volume as reference enabled us to assess the accuracy in a more precise way than the use of ultrasound. Despite the good discriminating power, the accuracy was not acceptable in higher quartiles in the younger group. If the trend of overestimation especially higher volume, could be understood prior to measurement, it would be helpful to assume the real val.
The children's module in BS showed excellent discriminating power and generally acceptable accuracy in more than four-year-old children. This may lose accuracy in higher quartiles among less than three years old children.
膀胱扫描仪（BS）是一种专门用于测量膀胱容量的便携式超声设备，已被开发并应用于评估排尿功能障碍患者的残余尿量，这是评估此类患者的必要手段。尽管临床中常因不愿进行导尿而倾向于使用膀胱扫描仪，但对于儿科人群，其应用经验仍然有限。本前瞻性观察研究旨在评估新开发的儿童专用膀胱扫描仪（BioCon-900）模块在测量 0-6 岁儿童膀胱容量方面的相关性和准确性。
本研究纳入了 29 例拟行脊髓脊膜膨出预防性松解术的患者。当他们接受膀胱测压以确认神经功能正常时，在记录的容量输注达到年龄调整后膀胱容量（EBC）的每个四分位数时，使用 BS 测量膀胱容量。以 EBC 的百分比（%EBC）表示测量体积与输注体积之间的差异（偏差）。分别采用相关系数和 Bland-Altman 图来确定其判别能力和准确性。可接受的限值设定为 30%EBC。
在整个年龄范围内，测量体积与输注体积之间存在很强的相关性（r=0.95，P<0.001）。这种极好的相关性在 3 岁以下和 3 岁以上的儿童中仍然相似。膀胱容量往往被高估，平均偏差为 33±22.3%EBC，且随着四分位数的增加而升高。在年龄较大组的所有测量范围内和年龄较小组的前两个四分位数内，准确性都是可接受的。
我们首次评估了 BS 在 0-3 岁儿童中的应用潜力，并将结果与已证明 BS 准确性的 4-6 岁儿童进行了比较。本研究的一个优点是纳入了膀胱容量的所有四分位数的数据。与使用超声相比，使用输注体积作为参考可以更精确地评估准确性。尽管具有良好的判别能力，但在年龄较小组的较高四分位数中，准确性不可接受。如果能够在测量前了解高估，特别是高容量的趋势，那么假设真实值会有所帮助。
BS 的儿童专用模块在 4 岁以上儿童中具有良好的判别能力和总体上可接受的准确性。但在 3 岁以下儿童中，较高四分位数的准确性可能会降低。
