[Portable ultrasonographic device and bladder dysfunction management in stroke patients]

To determine the usefulness of a portable ultrasonographic device in the management and rehabilitation of stroke patients' bladder voiding impairment in the early stage and to propose a well-fitted screening protocol.

A prospective observational study of 33 inpatients admitted into our stroke rehabilitation program. A urinary elimination assessment protocol defines the criteria of intermittent catheterization. The determination of bladder volume was performed with a Bladderscan BVI 3000 portable ultrasonographic device.

Urinary retention was present in ten of the 33 patients at admission, who were started on one or many intermittent catheterizations. Retention was resolved for seven of them at discharge. The portable ultrasonographic device allows a very accurate bladder volume assessment, especially useful in at-risk patients: those with cognitive impairments, diabetes mellitus, and prestroke urinary pathology. A new version of our first screening protocol increases the ability to detect patients with true urinary retention. Results are discussed according to the literature data.

The portable ultrasonographic device is a simple and noninvasive tool, useful for diagnosis, follow-up and therapy guidance of urinary retention after stroke. An adapted protocol is proposed in order to assess and rehabilitate this trouble. The goal is to avoid long-term catheterization and its linked infectious risk.