Mavani Parit T, Ajay Pranay S, Wagner Heather B, Meyer Benjamin I, Shah Monali, Sok Caitlin P, Gamboa Adriana C, Goyal Subir, Switchenko Jeffrey M, Maithel Shishir K, Kooby David A, Shah Mihir M
Division of Surgical Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA.
Department of Surgery, Emory Saint Joseph's Hospital, Atlanta, GA.
Surgery. 2025 Jul 8;185:109547. doi: 10.1016/j.surg.2025.109547.
Postoperative urinary retention warrants catheterization. A bladder scan helps check for postoperative urinary retention before catheterization. There is a paucity of data about its reliability in postoperative obese patients. Our study assesses its reliability in this patient population.
All patients in the postoperative ward of one hospital who underwent surgery during their current admission were included in our prospective cohort study. Patients were catheterized on the basis of the clinical judgment of the treating physician. The nurses collected bladder scan readings before catheterizing patients. Final analysis excluded patients with nongastrointestinal surgeries, record of fewer than 3 bladder scans readings, and missing urinary catheterized volume. The mean bladder scan readings (minimum = 3) were compared with the catheterized volume using intraclass correlation coefficient analysis.
Of 100 patients, 65 met our selection criteria. Bladder scan reliability was good (intraclass correlation coefficient. 0.69; 95% confidence interval, 0.55-0.80) in the overall study cohort. A strong linear relationship was noted between bladder scan and catheterized volumes (r = 0.774, P < .001). Excellent reliability was noted in body mass index <30 subgroup (n = 43, intraclass correlation coefficient, 0.76, 95% confidence interval, 0.61-0.86), whereas the reliability was fair in body mass index ≥30 subgroup (n = 20, intraclass correlation coefficient, 0.55, 95% confidence interval, 0.26-0.81). Patients with body mass index ≥30 had a larger median difference between scan and catheterized volumes compared to patients with body mass index <30 (94.2 mL vs 34.8 mL).
Our study demonstrates the accuracy and reliability of portable ultrasound bladder scans, especially in patients with healthy weight and overweight with postoperative urinary retention. The reliability may be suboptimal in obese patients.
术后尿潴留需要进行导尿。膀胱扫描有助于在导尿前检查术后尿潴留情况。关于其在术后肥胖患者中的可靠性的数据较少。我们的研究评估了其在这一患者群体中的可靠性。
我们的前瞻性队列研究纳入了一家医院术后病房中本次住院期间接受手术的所有患者。根据主治医生的临床判断为患者进行导尿。护士在为患者导尿前收集膀胱扫描读数。最终分析排除了接受非胃肠道手术的患者、膀胱扫描读数少于3次的记录以及导尿尿量缺失的患者。使用组内相关系数分析将平均膀胱扫描读数（最小值 = 3）与导尿尿量进行比较。
100名患者中，65名符合我们的选择标准。在整个研究队列中，膀胱扫描的可靠性良好（组内相关系数为0.69；95%置信区间为0.55 - 0.80）。膀胱扫描与导尿尿量之间存在很强的线性关系（r = 0.774，P <.001）。体重指数<30的亚组（n = 43，组内相关系数为0.76，95%置信区间为0.61 - 0.86）可靠性极佳，而体重指数≥30的亚组（n = 20，组内相关系数为0.55，95%置信区间为0.26 - 0.81）可靠性一般。与体重指数<30的患者相比，体重指数≥30的患者扫描与导尿尿量之间的中位数差异更大（94.2 mL对34.8 mL）。
我们的研究证明了便携式超声膀胱扫描的准确性和可靠性，尤其是在体重正常和超重且有术后尿潴留的患者中。肥胖患者的可靠性可能欠佳。
