Journal of Ultrasound in Medicine, Vol 19, Issue 4 237-241, Copyright © 2000 by American Institute of Ultrasound in Medicine
Is a full bladder still necessary for pelvic sonography?
B. R. Benacerraf, T. D. Shipp and B. Bromley
Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
The objective was to determine whether a full bladder is routinely
necessary for a complete sonographic evaluation of the female pelvis. Over
the course of 1 month, all women having a gynecologic sonogram were scanned
initially transabdominally through a full bladder by the sonographer
(standard images taken). A physician then joined the sonographer and
scanned the patient transvaginally without prior knowledge of the findings
seen transvesically. The physician finished the examination
transabdominally, with the bladder empty. The physician and sonographer
then determined (1) whether the scan was sufficient transvaginally only,
(2) whether the scan was sufficient transvaginally and transabdominally
with an empty bladder, or (3) or whether a full bladder was necessary. Two
hundred and six consecutive patients were scanned prospectively. The
transvaginal scan alone was sufficient to demonstrate all findings for 172
(83.5%) patients. The transvaginal and transabdominal scans through an
empty bladder were needed for 31 (15.1%) patients. Three patients (1.5%)
required a full bladder in addition to the other two techniques to
visualize one normal ovary each. In conclusion, transvaginal scanning with
an adjunctive transabdominal empty bladder approach can replace the full
bladder technique for routine pelvic sonography. The transabdominal scan
with an empty bladder is necessary, particularly for patients with enlarged
uteri. It is no longer reasonable, however, to subject all patients
undergoing pelvic sonography to bladder distention.
