PubMed · 13699411
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P P FIGDOR. 1960. [Passive congestion and kidney function].. https://pubmed.ncbi.nlm.nih.gov/13699411/
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INTRODUCTION: Bladder volume estimation is an everyday necessity in urology, especially for evaluation of the postvoid residual volume (PVR). The Bladder-Scan is a portable, noninvasive ultrasound device for bladder volume estimation. This study was designed to assess the value of the Bladder-Scan to measure PVR in routine hospital urological practice. MATERIAL AND METHODS: A prospective study was conducted from 1/12/1999 to 30/4/2000 with systematic use of the Bladder-Scan to measure PVR. Four operators performed three consecutive measurements of PVR and noted the following data: age, gender, history, type of disease and place of examination. The main endpoint was the need to use a complementary investigation to confirm or invalidate the result obtained. RESULTS: PVR was determined in 250 consecutive patients (167 males, 83 females): 191 patients admitted to the urology department, 36 patients seen in the emergency room and 23 patients seen in other departments of the hospital. PVR was estimated to be between 0 and 400 cc (median: 72 cc) for 181 patients (72%), between 400 cc and 750 cc (median: 521 cc) in 50 patients (20%) and between 750 cc and 1000 cc (median: 942 cc) for 19 patients (8%). A control of the measurement was required for 27% of patients (68/250) using catheterism (n = 53) or sonography (n = 15). In this sub-group, the value of the ICC (intra-class correlation coefficient) for the measurement of the bladder volume using the Bladder-Scan and measurement of the volume controlled by sonography or catheterism was of 0.9888 (significance < 0.0001/nil hypothesis ICC = 0). CONCLUSION: The Bladder-Scan provides a "third hand" in the urologist's daily practice, by supplying a reliable and rapid assessment of bladder volume for volumes < 750 cc. It is a good tool for the evaluation of postvoid residual volume.
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OBJECTIVES: To evaluate the patterns of urodynamic studies (UDS) use among community urologists. Much controversy exists with regard to the need and indications for UDS in the clinical evaluation of urinary incontinence (UI) and voiding dysfunction (VD). METHODS: A one-page questionnaire containing 11 questions was mailed to urologists practicing in the Rocky Mountains region. Physicians were asked about (a) their type of practice; (b) the number of patients with UI and VD they see per week; (c) the number of office procedures they perform on these patients; (d) the percentage of patients with UI and VD for whom they use UDS for diagnostic clarification; and (e) the limiting factors to more frequent use of UDS. RESULTS: Of the 127 questionnaires mailed, 51 (40%) were returned, and 49 (39%) of these were returned "completely filled out." No follow-up letter was sent nor was a telephone interview done. Most urologists (n = 38; 76%) indicated they are in private practice, 5 (10%) are in academics, 3 (6%) are in multispeciality groups, 2 (4%) are affiliated with a health maintenance organization (HMO), and 1 is in a hospital-based practice. Twelve (24%) see fewer than 5 UI patients per week, 21 (43%) see 5 to 10 UI patients per week, and 16 (32%) see more than 10 UI patients per week. The respective numbers for VD patients seen per week are 4 (8%), 12 (24%), and 33 (67%). Thirty (61%) and 32 (65%) of respondents use UDS in fewer than 5% of patients seen with UI or VD, respectively. Thirty-seven (76%) use cystoscopy in more than 5% of patients seen with UI or VD. Regarding limiting factors for more frequent use of UDS (of those 35 urologists giving single answers), 60% believed there was a lack of indication and 40% noted that UDS are too time-consuming or not cost-effective (20%), difficult to interpret (5.7%), or that they had no access to such equipment (14%). CONCLUSIONS: This study shows that the majority of urologists perform cystoscopy more frequently than UDS for diagnostic clarification of patients with UI and VD, and 40% of urologists do not perform UDS for reasons other than lack of indication. These results may indicate a need for more access to, and additional training in, UDS among urologists for management of UI and VD.