Abstract: Use of a Portable Ultrasound Device to Measure Post-Void Residual Volume Among Incontinent Nursing Home Residents

Joseph G. Ouslander, Sandi Simmons, Edward Tuico, Jennifer Glatler Nigam, Susan Fingold, Barbara Bates-Jensen, and John F. Schnelle. "Use of a Portable Ultrasound Device to Measure Post-Void Residual Volume Among Incontinent Nursing Home Residents." Journal of the American Geriatric Society 42 (November 1994) 11: 1189-92.

Objectives:
* To determine the accuracy of a portable ultrasound device for the assessment of post-void residual (PVR) volume among incontinent nursing home residents. PVR is an important component of the assessment of nursing home residents' bladder function, as undetected urinary retention can contribute to urinary incontinence and predispose residents to urinary tract infection, hydronephrosis, and chronic pyelonephritis.

Methods:
* The PVR volumes of two-hundred one incontinent nursing home residents in seven community-based nursing homes were measured using ultrasound. Ultrasound measurements of bladder volume were then compared to volumes obtained by catheterization. The accuracy of the ultrasound was calculated using the volume obtained by catheterization as a gold standard. This study took place over a period of three years. Most ultrasound measurements of bladder volume were made using the BVI 2000. During the course of the study, the BVI 2500 was developed, and the newer device was used for 61 of the subjects. The results obtained using the BVI 2500 were highly correlated with those obtained using the older model.

Results:
* "The ultrasound demonstrated excellent test-retest and interrater reliability. For low PVRs, the device was highly sensitive (.90 for PVR <50 mL and .95 for PVR <100 mL) and moderately specific (.71 for PVR < 50 mL and .63 for PVR < 100 mL). For PVRs of more than 200 mL (n = 26), the ultrasound had a sensitivity of .69 and a specificity of .99."

Conclusions:
* "Ultrasonic measurement of PVR volume is being used increasingly in the office practice of urology, inpatient rehabilitation units, and in acute hospitals. Our data suggest that the portable ultrasound device may also be useful in the nursing home setting."
* "The portable ultrasound we used was reliable and reasonably accurate for assessing PVR in a representative sample of incontinent nursing home residents."

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