The pitfalls of BladderScan™ PVR in evaluating bladder volume in adolescent females

Post-void residual (PVR) determination is an integral part of the evaluation of children presenting with lower urinary tract symptoms. Historically the PVR volume has been obtained by urinary catheterization after the child has voided, however, with the advent of ultrasound technology, PVR was determined in a noninvasive fashion by radiology personnel. Currently, PVR determinations may be obtained by healthcare personnel (without specialized training) using a portable, self calculating ultrasound; the BladderScan. While BladderScan PVR has been shown to be accurate and reproducible, it cannot differentiate between a distended bladder and other cystic pelvic structures. Several case reports have been published illustrating falsely elevated PVRs by bladder scan in adults with cystic pelvic structures. We present two adolescent females with LUTS who had falsely elevated PVRs by bladder scan, who, subsequently, underwent formal imaging to identify ovarian cystic pathology. To our knowledge, this is the first report of falsely elevated bladder scan PVR in children related to cystic pelvic organ pathology.