![]() ![]() 1 In this case, the patient was just on the cusp of normal vs abnormal post-void urinary volume, but with his other clinical signs and symptoms, warranted emergency spine consultation and MRI. Two hundred milliliters or greater is generally regarded as the threshold for retention. Current literature defines normal post-void bladder volume in adults as < 50 mL in patients under 65 years of age, and < 100 mL in those older than 65. Calculation of bladder volume using the ellipsoid method (L x W x H x 0.52 = mL)įindings concerning for Cauda Equina were all present in this patient’s history, physical exam, and workup. After use of a urinal, bedside POCUS was used to measure his post-void residual bladder volume:įigure 3. He reports that he is able to urinate but unable to state if his urinary frequency has increased beyond “my normal prostate issues.” He notes he has fallen twice because “my legs just seem to give out on me.” On physical exam, he demonstrates 4+/5 bilateral LE strength, mild distal sensory loss, and absent patellar and Achilles reflexes. ![]() He denied fever, abdominal pain, and dysuria. Soucy, DO, FACEP, Co-Chair, System Wide Clinical Ultrasound Subcommittee, Assistant Professor, Emergency Medicine Director, Emergency Ultrasound Director, Emergency Ultrasound Fellowship, Co-Chair, System Wide POCUS, Dartmouth-Hitchcock Medical Center, Geisel School of Medicine, DartmouthĪ 65-year-old male with a history of HTN, BPH, IDDM, and lumbar spinal stenosis presented to the ED with low back pain and lower extremity weakness. Woods, MD, FACEP, Co-Chair, System Wide Clinical Ultrasound Subcommittee, Emergency Physician, INOVA Fairfax Hospital, Clinical Assistant Professor, George Washington University ![]()
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