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Clinical Significance of Bladder Scanners in Urinary Retention

by David Smith

| Updated October 10, 2023 |
Catheterization has long been considered the gold standard for determining postvoid urinary volume. But for both patients and healthcare providers, the invasive nature of catheterization comes with a list of disadvantages, including patient discomfort.

To counter these disadvantages, clinicians now opt for portable bladder scanners as a less invasive method of diagnosing urine retention. In fact, healthcare experts consider bladder scanning the safest method for detecting urinary retention.

So, exactly what is the significance of bladder scanners in clinical practice?

Bladder scanners display 3D bladder images and record accurate urine volume, allowing health practitioners to make informed decisions about the need for catheterization. Besides, bladder scanning is a painless and comfortable procedure with no risk of urinary tract infections.

This article is a detailed account of the clinical importance of bladder scanners in urinary retention. Apart from discussing the benefits of bladder scanners in clinical practice, it will explain the causes, symptoms, and complications of urine retention.

Let’s start with a quick description of urinary retention as a preface for understanding why bladder scanners are crucial urinary retention diagnostic tools.

1.What is Urinary Retention? 

When the brain sends a signal that the bladder needs voiding, the natural thing to happen should be that all the urine in the bladder goes out through the urethra. However, certain situations can hinder complete bladder voiding, leading to urinary retention.
Urinary retention presents when a person does not completely empty the bladder during voiding. Instead, some urine remains in the bladder as postvoid residual (PVR).
Residue urine can be a health threat, which is why clinicians use bladder scans to determine if the volume level is safe. Unsafe residual urine levels require bladder emptying through catheterization.
But what are the clinical signs and symptoms of urinary retention? Let’s answer that next.

2.Signs and Symptoms of Urinary Retention

The presence of urinary residue after voiding is the primary sign of urinary retention. PVR can present with noticeable signs or be without any symptoms.

Usually, acute urinary retention has noticeable clinical symptoms, including the following:

●Abdominal bloating, with or without pain in the suprapubic area.
●Urinary incontinence or involuntary urine passage.
●A frequent urge to pass urine.
●Straining at the start of and during voiding, sometimes with interrupted urine flow.
●A state of acute confusion (delirium) from extreme bladder distension, especially among children, seniors, and patients with dementia.
●Urinary tract infections due to bacteria growth in residual urine.

To present these signs, individuals or patients with urinary retention must have encountered situations that trigger incomplete bladder voiding. Let’s look at those situations that cause urinary retention.

3. What Causes Urinary Retention?

Urinary retention is a problem of the urinary system. For that reason, it is crucial to know the structures of the urinary system in order to understand the causes of urinary retention.

The kidneys are at the upper end of the urinary system. They clean the blood to eliminate waste and send it as urine to the bladder through the ureters. Once the bladder is full, the urethra muscles relax to send the urine out.

Urinary retention is caused by neurogenic, inflammatory, infectious, functionality, drug-related, congenital, and anatomical problems.

Let’s discuss the specific urine retention causes under each of these general causes.

4.Neurogenic Causes

The Central Nervous System (CNS) controls bladder voiding by sending signals to the bladder and urethra muscles to constrict when the bladder is not full or relax when voiding.

Neurogenic causes of urine retention affect the communication between the CNS and the bladder and urethra muscles. They are the reason your physician will say you have a neurogenic bladder.

The list of neurogenic causes of urinary retention is long and includes the following:
●Spinal cord injuries.
●Brain injury from trauma.
●Bladder nerve dysfunction due to injury or pelvic surgery.
●Post-surgical urinary retention.
●Cerebral palsy.
●Spina Bifida.
●Parkinson disease.
●Multiple sclerosis.
●Diabetes mellitus.
●Spine and CNS tumors.
●Vitamin B12 deficiency.

5. Inflammatory and Infectious Causes

These are urinary retention causes triggered by bacterial or viral infections and inflammatory conditions. They include:

●Herpes virus.
●Cystitis (inflammation of the bladder).
●Urethra abscesses.
●Prostatitis (inflammation of the prostate gland).

Note that some neurogenic causes listed earlier also trigger the inflammatory and infectious causes of urinary retention. A good case is Cystitis in diabetes patients.

6.Congenital and Anatomical Causes

These are urinary retention causes related to modifications in the structure or functioning of the urinary system. They can be hereditary or acquired and include:

●Bladder diverticula (a congenital or acquired pouch in the bladder wall).
●Foreign objects in the urethra.
●Phimosis (penis head blockage by the foreskin).
●Posterior urethral valves (congenital blockage of the male urethra by extra tissue).

Mechanical Causes

Mechanical causes of urine retention affect the ordinary functioning of the urinary system. They include:

●Blood clots in the urinary system.
●Bladder tumors.
●Prostate cancer.
●Cystocele (weakened bladder and vagina walls).
●Fecal impaction (Stool buildup in the colon due to severe constipation).
●A narrow urethra.
●Uterine prolapse (weakened pelvis muscles), including after childbirth.

Drug-related Causes

Drug-related urinary retention causes occur as a result of the consumption of medications such as:

●Antihistamines (anti-allergy drugs).
●Amphetamines (stimulant drugs).
●Anticholinergics (they alter the functioning of the CNS).
●Bladder Botox injections.
●Opioids (pain relievers).

Urinary retention can also result from other bladder problems, including urinary incontinence. The uncontrolled flow of urine leaves urine residue in the bladder.

For all these causes, post-residual urine can serve as an indicator of poor bladder functionality. They can point to urinary retention symptoms that help clinicians make an accurate diagnosis and provide the necessary therapy.

It goes without saying that untreated urinary retention can cause unwanted complications.

Complications of Urinary Retention

The most obvious complication of urinary retention is bacterial breeding, which leads to urinary tract infections (UTIs).

With time, however, urinary retention can also cause damage to the bladder and other organs of the renal system, like the urethra, kidneys, and ureters.

Because of the resulting bacteria and pathogens, urine retention can cause urosepsis, a series of autoimmune reactions. These are extremely dangerous and can eventually turn fatal.

All these complications come with pain, which can become chronic and compromise a patient's quality of life.

Because prolonged urinary retention eventually needs catheterization, it can cause secondary infections due to pathogens introduced to the bladder with the catheter. In fact, studies suggest that catheter-related infections are a primary cause of secondary infections in the bloodstream.

A co-occurring complication with urinary retention is urinary incontinence. The urine leaks slowly and gradually because the bladder does not void normally.

In severe urinary retention cases, residual urine can flow back to the kidneys, causing extensive renal dysfunction.

In cases where bladder emptying after urinary retention causes diuresis (increased urine flow), a patient may experience electrolyte imbalance. This comes with symptoms like headache, nausea and vomiting, constipation, diarrhea, and general irritability.

Considering these complications, portable bladder scanners are a crucial diagnostic tool for clinicians.

Clinical Uses of Bladder Scanners (Clinical Benefits of Bladder Scanners)

Using bladder scanners in clinical practice comes with a range of benefits. And although we readily think of the advantages of bladder scanners for patients, these portable bladder scanner machines also have plenty of benefits for medical practitioners.

For clinicians and other health care providers, the accurate results of bladder scans provide reliable data on which they can make decisions pro or con patient catheterization. Postponing catheterization after a bladder scan comes with several benefits for patients:

●It saves patients the discomfort and pain of catheterization when unnecessary.
●It reduces treatment costs.
●It saves patients from catheter-related urinary tract infections, significantly reducing the number of days a patient needs to stay hospitalized.

Skipping patient catheterization when not required following post-catheterization bladder scans also increases healthcare personnel morale. That’s because it saves them the trouble and time for catheter application.

The use of bladder scanners alongside a 24-hour voiding diary helps clinicians and nurses give a precise diagnosis of bladder voiding dysfunctions. For example, clinicians can use bladder scan results to differentiate between urinary incontinence, an overactive bladder, and polyuria (excessive urine volume).

In addition, the bladder scanning technique is easy to learn and perform, and any healthcare provider can perform it after only a few minutes of training.

Overall, portable ultrasound bladder scanners are non-invasive and, therefore, a healthier option for patients with bladder problems.

To maximize the clinical benefit of bladder scanning, healthcare practitioners need to know how the bladder monitoring equipment works.

How Do Bladder Scanners Work?

A portable bladder scanner is a two-part medical equipment consisting of a transducer or probe and an LCD screen. Some models have optional or inbuilt trolleys or table-top holding trays for ease of use in different healthcare environments.

When you perform a bladder scan, the probe sends ultrasound waves from the bladder to the scanner computer. The computer interprets the waves and sends them back to the monitor as 3D images of the bladder and urine volume.

To achieve this, the clinician should follow this step-by-step procedure:

1.Ensure a sterile bladder scanning environment by wearing gloves and cleaning the probe head.
2.Ask the patient to lie down in a supine position (with face and chest facing up).
3.Apply an ultrasound gel on the suprapubic area and pass the probe while pointing directly to the bladder.
Depending on the Bladder scanner model, you may need to press a scan button and select the patient type.
4.Observe the 3D bladder images and urine volume score on the LCD screen and interpret the results to decide pro or con catheterization.

As a rule of thumb, bladder volumes ≥500mL point to urine retention and should be addressed with immediate voiding by catheterization. If not done, risky bladder distention can occur.

The bladder scanning procedure may vary slightly depending on the model of the bladder scanner machine.

You can watch the complete video of how to use a portable bladder scanner for our recommended BladGo model here.

Also, apart from knowing how to use a bladder scanner, healthcare providers should know when to use the ultrasound scanner.

When to Use and Not to Use a Bladder Scanner

Bladder scanners are optimal postvoid residual diagnostic tools in a range of settings, including:

●Clinics and hospitals.
●Long-term and acute care.
●Physicians offices.

That said, it is important to remember that bladder scanning is not for all patient types.
This table lists the situations when healthcare practitioners should use bladder scanners and when they should avoid them.
bladder scanner use benefits image
Whichever your patient's case, clinicians should opt for the most accurate bladder scanner brands on the market.

Choosing a Bladder Scanner: Our Recommended Model (BladGo 2.0)

bladgo handheld bladder scanner ad picture
Choosing the best portable bladder scanner for your clinical practice can be challenging. After all, there are numerous bladder scanner models on the market.

To ensure you are getting the best, consider the efficiency features of your choice bladder scanner. Such features include:

●A high accuracy level.
●Ease of use.

Based on these features, we recommend the BladGo 2.0 bladder scanner. This scanner has a reliable accuracy level of ±15mL,±15%. Such accuracy gives a good margin for deciding pro or against catheterization. You also get real-time scan results in 12 cross-sectional images alongside 4 urine volume records.

The BladGo bladder scanner is easy to use. You simply place the probe on the patient’s lower abdomen, choose the patient type from the available 5 options, and press the scan button. Besides, the bladder scanner comes with a table-top rubber base, and you can purchase a rolling trolly separately to move the bladder scanner around.

The manufacturer gives you great offers and discounts, including a $1,000 reduction from the original $4,799 BladGo bladder scanner cost to $3,799. You also get free shipping, a 2-year warranty, and a 14-day money-back guarantee.

Concluding Thoughts

Urinary retention is a bladder dysfunction that clinicians have to deal with often. While catheterization was considered the best method for resolving urinary retention, today’s bladder scanners have made the lives of clinicians and patients a lot easier.

When considering the clinical importance of bladder scanners in urinary retention, the first benefit to come to mind is that they are non-invasive. Besides, they save patients the pain and infection risk posed by catheters.

For healthcare practitioners, bladder scan results save them the time and trouble of applying catheters when unnecessary. That’s as long as they choose bladder scanners with high accuracy levels.

Reference Articles

Davis, C. et al (2012) To scan or not to scan? Detecting urinary retention. Nursing Made Incredibly Easy! 10:4, 53-54.

Dharmarajan, T.S. et al (2015) Hyperactive Delirium from a Distended Urinary Bladder and Retention: Delayed Diagnosis and Needless Medications May Beget More Adverse Events and Institutionalization. Journal of the American Medical Directors Association; 16:3, B6-B7.

Leslie S.W. et al (2023) Neurogenic Bladder and Neurogenic Lower Urinary Tract Dysfunction. StatPearls [Internet]: StatPearls Publishing. 

Brock, G.M. et al (2022) Emphysematous Cystitis and Urinary Retention in a Male Patient With Diabetes Mellitus Type 2 Treated With Empagliflozin. Clinical Case Reports; 8:4, 163-165.

Halaseh, S.A., Leslie, S.W. (2023) Bladder Diverticulum. StatPearls [Internet]: StatPearls Publishing. 

McPhee A.S. et al (2023) Phimosis. StatPearls [Internet]: StatPearls Publishing. 

Werneburg G.T. (2022) Catheter-Associated Urinary Tract Infections: Current Challenges and Future Prospects. Research and Reports in Urology, 4:14,109-133.

Chen S.C. (2018) Portable Bladder Ultrasound Reduces Incidence of Urinary Tract Infection and Shortens Hospital Length of Stay in Patients With Acute Ischemic Stroke. Journal of Cardiovascular Nursing; 33:6, 551-558.

Leslie S.W. (2023).Female Urinary Retention.StatPearls [Internet]. StatPearls Publishing. 
Article by
David Smith
David is a urologist with over 9 years of experience. He is also the Co-fonder of BladGo, where he regularly shares his expertise in the field of urology. David is committed to keeping readers up-to-date on the latest urological research and to sharing other beneficial healthcare tips and information so that they can live healthier lives.

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