Comparison of manual and ultrasonographic evaluation of bladder size in patients prior to laparoscopy

Surg Endosc. 1996 Apr;10(4):432-3. doi: 10.1007/BF00191633.


Background: Catheterization of the bladder may reduce laparoscopic complications although an enlarged bladder may be impalpable in overweight patients or following previous lower abdominal surgery.

Methods: This study assessed bladder size by manual examination and transcutaneous ultrasound (US). Consecutive patients (n = 90; median age 55 years [20-85]; 61 females) undergoing laparoscopy were studied prospectively. All patients voided preoperatively and catheterization was performed if estimated US bladder volumes exceeded 300 ml.

Results: Manual assessment failed to detect bladder enlargement in any patients (sensitivity: 0%; specificity: 4.4%), whereas ultrasound identified four patients at risk of bladder injury due to unsuspected enlargement (4.4%). Three of these patients were either overweight or obese and one patient had previous lower abdominal surgery. Of 12 patients (13%) catheterized, three had or developed urinary tract infections.

Conclusions: Preoperative voiding does not guarantee bladder emptying. Manual examination does not detect bladder enlargement reliably in the obese patient. Ultrasonography may improve patient selection for catheterization.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Body Mass Index
  • Catheterization
  • Cholecystectomy, Laparoscopic*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Preoperative Care
  • Prospective Studies
  • Retrospective Studies
  • Ultrasonography
  • Urinary Bladder / anatomy & histology*
  • Urinary Bladder / diagnostic imaging*