In children, a PVR volume exceeding 10% of the urinary bladder capacity is pathological (Riedmiller et al., 2001). PVR volumes over 100–ml are considered significant in adults. Depending on the bladder shape, considerable inaccuracy is possible. Various factors ranging from 0.5–0.7 are found in the literature. Postvoid residual volume (PVR) = Length × Width × Height × 0,5 The postvoid residual volume is calculated using the formula: Measurement of Postvoid residual volume (PVR):Īfter micturition, the bladder's length, width, and height are recorded in sagittal and horizontal planes. Ultrasonography of the bladder: measurement of postvoid residual volume using formula: Length × Width × Height × 0.5. In children, values above 2.5 mm are pathological and suspicious for subvesical obstruction. In adults, 7 mm is the upper limit for bladder wall thickness. The bladder wall should be measured with a filled bladder (greater than 50% of the capacity) on the anterior wall of the bladder. Depending on the size of the prostate, the middle lobe protrudes into the urinary bladder and may be misinterpreted as a bladder tumor. In the area of the trigonum, the ureteral orifices and the bladder neck can be recognized. The filled bladder has an echogenic wall that is sharply defined without wrinkles or bulges. The urinary bladder is an echo-free filled hollow organ, but often ultrasound artifacts mimic echogenic structures in the urinary bladder (reverberations or side lobe artifacts). At the end of the investigation, the postvoid residual (PVR) urine volume is measured if the patient reports lower urinary tract symptoms. The bladder is systematically examined in the longitudinal (sagittal) and transverse planes. The examination requires a filled bladder. The transducer used for bladder ultrasound is a sector or curved array probe with 3.5–5 MHz. Indications include (but are not limited to): abdominal pain, flank pain, hematuria, proteinuria, lower urinary tract symptoms, abdominal trauma, (recurrent or febrile) urinary tract infections, increased retention parameters, nephrolithiasis, in patients with kidney transplantation, planning and performing surgical procedures of the prostate or bladder, urinary incontinence, and dyspareunia. Ultrasonography of the bladder is a frequent examination in urological patients. You are here: Urology Textbook > Urologic examinations > Imaging > Bladder ultrasound Bladder Ultrasound and Measurement of Postvoid Residual Volume Dilated rectum is associated with abnormal voiding parameters.Bladder Ultrasound and Measurement of Postvoid Residual Volume Rectal dilation was associated with abnormal voiding parameters (p = 0.015).Ībnormal voiding parameters including voided volume and post-void residual urine are prevalent in constipated children. Mean RD in normal and abnormal parameters groups was 2.8 and 4.7 cm, respectively.
On the whole, the prevalence of abnormal voiding parameters in constipated children was 52.9 %. Three children (17.6 %) had both abnormal VV and PVR. Post-void residual urine varied from 0 to 85 ml and was abnormal in six (35.5 %) children. Voided volume ranged from 30 to 289% of EBC and was abnormal in six children (35.5%). Vmax was normal in all children (median = 23.7 ml/sec). Rectal diameter ranged from 1.7 to 8.2 cm (median = 3 cm) and was abnormally dilated in eight children. Abnormal voiding parameters were defined as Vmax 150% of age-adjusted expected bladder capacity (EBC) and/or PVR >20 ml. Each patient had uroflow measurement and bladder USG done to measure the maximal flow rate (Vmax), voided volume (VV), and post-void residual urine (PVR). The rectal diameter (RD) was measured by transpubic ultrasonography (USG), RD >3.5 cm was considered as dilated. Since 2010, seventeen consecutive children (12 boys, 5 girls) aged 5-17 (median = 14) with significant constipation according to Rome III criteria and who were not responding to conventional treatment (diet, laxatives & bowel training) for over 6 months were recruited. In this study, we investigate the voiding parameters in children with constipation. It is suggested that idiopathic constipation may associate with abnormal voiding parameters.
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