Testing under clinical situations can result in incomplete and artificially elevated PVR volumes. Sequential measurements are therefore advised. Methods to estimate PVR include—
a. Ultrasound (true volume often underestimated but most practical)
b. Instrumentation (catheter or cystoscope)
c. Radiography (IVU or videourodynamics)
d. Radioisotopes (gamma camera)
It is also important to record—
• The time from micturition to PVR estimation (the latter should ideally immediately follow the former, especially if the patient is undergoing a diuresis)
• Presence of any bladder diverticula (urine in a large diverticula may or may not be included in PVR estimation)
Occasionally in children, re-entry of refluxed urine back into the bladder following micturition may be confused with PVR.
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