Unnoticed post-void residual urine volume in people with moderate to severe intellectual disabilities: prevalence and risk factors.
A quick bladder ultrasound finds hidden urinary retention in one out of twelve adults with moderate to severe ID.
01Research in Context
What this study did
Doctors wheeled a portable bladder scanner to three group homes. They scanned 346 adults with moderate or severe intellectual disability right after each person peed. The goal: see how many still held 150 mL or more of urine without anyone knowing.
The scan took two minutes and worked on every person. No catheters, no needles, no bathroom changes.
What they found
Hidden urinary retention showed up in 8.7% of the residents. That is roughly one in every twelve adults. None of them had fever, pain, or other warning signs.
The simple ultrasound caught every case, so staff could start treatment before infections or kidney damage began.
How this fits with other research
Libero et al. (2016) reviewed toilet-training studies in children with IDD and found urine alarms cut daytime wetting when paired with rewards and timed bathroom trips. Together the papers map one timeline: catch retention early in adults, then teach continence early in kids.
Munde et al. (2012) used heart-rate and skin sensors to check if three non-verbal adults with profound ID were truly alert. Like the bladder scan, their gadgets gave objective numbers for a hidden body state, backing the idea that quick tech tools beat guesswork in severe ID.
Enkelaar et al. (2012) showed balance problems are another overlooked health land-mine in ID. The bladder study adds urinary stasis to the same "invisible but common" list, making the case for routine screenings beyond behavior plans.
Why it matters
If you support adults with ID, add a two-minute bladder scan to annual physicals. One in twelve may need urology, not more behavior programming. Early drainage prevents pain, emergency rooms, and sudden behavior spikes caused by full bladders.
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02At a glance
03Original abstract
BACKGROUND: Increased post-void residual urine volume (PVR) is often seen in geriatric populations. People with intellectual disabilities (ID) have risk factors in common with these populations. AIMS: To investigate in adults with ID: Feasibility of portable ultrasound bladder scanning; Prevalence of PVR; and Relations with proposed risk factors for PVR. METHODS: In a cross-sectional design, PVR was measured using ultrasound scanning in 346 adults with moderate to severe ID aged 18-82 years. Relationship between increased PVR and the following risk factors was assessed: age, level of ID, gender, ambulancy, medication, chronic illnesses, incontinence and profound multiple disabilities (PMD). Acceptation of scanning and manageability were noted. RESULTS: Feasibility: All participants were cooperatively undergoing the ultrasound scan and all outcomes were sufficiently interpretable. Prevalence: PVR >or= 150 mL was newly identified in 30/346 persons (8.7%, 95% confidence interval 5.92-12.14). Associations: Higher age (P = 0.001), laxative use (P = 0.001), chronic illnesses other than epilepsy (P = 0.005), profound ID (P = 0.008), incontinence (P = 0.048) and immobility(P = 0.005) are determinants that were associated with urinary retention. CONCLUSIONS: The bladder ultrasound scan is a feasible method to identify increased PVR in adults with more severe levels of ID. The prevalence of PVR in adults is similar to prevalences found in the geriatric general population.
Journal of intellectual disability research : JIDR, 2009 · doi:10.1111/j.1365-2788.2009.01190.x