Bladder Volume Measurement using Bladder Manager PCI 5000 in Spinal Cord Injury Patients

ABSTRACT

A portable ultrasound scanner has been developed to provide a noninvasive technique of measuring the bladder urine volume. This study was undertaken to determine if bladder volumes could be accurately measured in a group of spinal cord injury patients on a clean intermittent catheterization program, using a portable ultrasound scanner(BladderManager PCI 5000). We assessed the effects of different patient positions, presence of central obesity and bladder types by the urodynamic study on the accuracy of measurements as well as the inter-tester difference. Ultrasound measurements of urine volume performed by two physicians were compared to the volumes obtained by catheterization in 17 spinal cord injury patients. Subjects were tested in the seated and supine positions. The results showed a good correlation between the catheterized volumes and ultrasound measurements (Pearson correlation coefficient=0.97, r2=0.88). The mean % error was 18% for the catheterized volumes within the ranges of 45ml-640ml. But the ultrasound measurements revealed a significantly higher % error for the bladder volumes less than 200ml. Ultrasound measurements were more accurate in a supine position and among the non-obese subjects(p<0.05). There was no significant difference in the ultrasound measurements between areflexic type bladder and hyperreflexic type bladder neither in the inter-tester measurements. We conclude that the Bladder Manager PCI 5000 is not an accurate tool for the assesssment of post-void residual urine volumes, however it can be a useful tool for the patients with neurogenic bladder who are performing volume-directed clean intermittent catheterization, in reducing the unnecessary catheterization or preventing the bladder overdistensions.