Is the Pocket Ultrasound the “Phonendoscope” of the Urologist?

Abstract

The objective was to evaluate the utility of the “pocket ultrasound” in making clinical decisions in urologic emergencies. From May to September 2011, 105 patients were assessed for urologic emergencies: acute flank pain, macroscopic hematuria, urinary retention, and lower urinary tract symptoms. All patients underwent an ultrasonographic examination whereby the pocket ultrasound was used to evaluate the kidneys and bladder, followed by another appropriate diagnostic test to verify the suggested diagnosis. Urinary retention was diagnosed in 10 patients. Of 48 subjects with hematuria, 34 had an immediate diagnosis: there were 18 cases of a bladder tumor, 13 cases of urolithiasis, and 2 cases of renal cell carcinoma; one ureteral stent was detected. Of 30 patients referred with lower urinary tract symptoms, 14 showed a high post micturition residual and 2 were seen to have bladder diverticula. Of 17 patients with acute flank pain, 1 had a kidney abscess, 5 had hydronephrosis, and 11 had urolithiasis. Ultrasonography provided a conclusive diagnosis in 67.6% of cases. Point-of-care pocket ultrasound allows a rapid diagnosis for treatment or triage of patients for appropriate referral to other diagnostic methods.