Transabdominal Ultrasound in the Assessment of Postvoid Residual Urine Volume in Patients after Hysterectomy
Tripop Lertbunnaphong MD*, Perapong Inthasorn MD*, Dittakarn Boriboonhirunsarn MD, MPH, PhD*, Monsak Chuchotirot MD*, Kusol Russameecharoen MD*, Buraya Phattanachindakun MD*
Affiliation : * Department of Obstetrics and Gynecology, Faculty of Medicine, Siriraj Hospital, Mahidol University
Objective : To evaluate the correlation between assessment of postvoid residual urine by transabdominal
ultrasound and catheterization in patients after radical or transvaginal hysterectomy.
Materials and Methods : A cross-sectional study was conducted and 46 patients were enrolled after they had
radical and transvaginal hysterectomy. After surgery, urinary catheter was indwelled. After catheter removal
and the 3rd private voiding, the patients were sent for transabdominal ultrasound assessment of PVR at the
Division of Maternal-Fetal Medicine. Complete drainage of bladder with standard catheterization was then
performed and catheterized urine volume was recorded. PVR was calculated from previously published equa-
tion and compared with actual PVR from catheterization.
Results : Mean age of the patients was 55.9 years. The most common diagnoses were procidentia uteri (23.9%),
Carcinoma of cervix stage 1b1 (23.9%), and prolapsed uteri grade 2 (21.7%). Radical hysterectomy with
pelvic node dissection and vaginal hysterectomy with anterior colporhaphy and posterior colpoperiniorhaphy
was performed each in 50% of cases. Mean duration of urinary catheter indwelling was 7.17 days for those
underwent radical hysterectomy and 5 days for vaginal hysterectomy. The calculated PVR was significantly
correlated with catheterized urine volume with correlation coefficient 0.93 (p < 0.001). If the usual cutoff of
PVR > 100 ml was used to determine the necessity of re-indwelling catheter, among those with calculated PVR
from ultrasound measurement < 100 ml, still 30% actually had actual PVR of > 100 ml. Among those with
calculated PVR from ultrasound measurement >100 ml, all actually had actual PVR of > 100 ml.
Conclusion : PVR estimation by ultrasound significantly correlated with actual PVR. This could reduce the
process of repeat catheterization and give more comfort to the patients when the PVR is > 100 ml.
Keywords : Ultrasound, Postvoid residual urine volume
