"Ultrasound of Bladder"

About: University Hospital Lewisham

I am a male aged 60. I attended for a bladder ultrasound on 27th February and was asked to attend with a full bladder. The procedure requires a scan to be done with the full bladder and again after emptying to check on residual urine volume. I had the scan done because of failure to fully empty, post void dribbling and occasional extreme urgency. My care and treatment was exemplary but I have an important observation to make. To carry out the first scan I had to lay on the table and the sonographer gave me some paper towel roll to tuck around the waistband of my trousers; he then had to force the ultrasound head under the waistband putting extreme pressure on my bladder. I suggested undoing the top button on my trousers to make it easier but he said this was not necessary. I was extremely worried that, with a full bladder, and the pressure and movement of the ultrasound head could cause either leakage or unintentional voiding. Had this occurred my clothing would have got wet and it would have been very embarrassing leaving the unit and travelling home having obviously wet myself. I understand the ethos of patient modesty and privacy but, in my opinion, this procedure would be better carried out with the lower clothing lowered to knee level and either a pad or towelling placed so as to capture any leakage; or the wearing of a gown, again with a pad or towelling to capture leakage. This would also have the advantage of making the manipulation of the ultrasound head easier since it could be against bare skin in the right place and aid patient comfort. The ultrasound rooms have closed doors and curtains so the modesty issue is well covered and, should sonographers or patients have any concerns of exposure the patient could be asked if they would like a sheet to cover the pad/thighs (genitals would be covered by the pad/towelling) – much like in colonoscopies and sigmoioscopies both of which I have also had at Lewisham.

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Response from University Hospital Lewisham

Reading this account from a patient’s perspective highlights a communication issue which will be reiterated to all sonographers at UHL, that each person needs to be respected as an individual and that what may be right for one patient may not sit well with another. From what has been said we will be highlighting that the sonographer should ask what the patient is most comfortable with for their examination and accommodate this. They can use the paper towel to act as a pad, which may make the patient feel somewhat more secure, especially as the need to put pressure on during the scan is necessary to obtain diagnostic images. We see the patient’s comments in a constructive manner and will use them as a timely example to sonographers to view things from the patient’s point of view and therefore would like to take the opportunity to thank this gentleman for his comments, which hopefully will improve examinations for future patients. Malcolm J McNinch Head of Imaging University Hospital Lewisham 0208 333 3000 x 6835

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