Application of Point-of-Care Ultrasound in Predicting Spontaneous Voiding in Postoperative Gynecological Patients with Urinary Urgency After General Anesthesia

Objective To explore the application value of point-of-care ultrasound (POCUS) in evaluating postoperative gynecological patients who complain of urinary urgency during the recovery period after general anesthesia, to clarify the cause of urgency, identify the risk of urinary retention, and provide a reference for catheterization decisions. Methods A total of 50 postoperative patients who experienced urinary urgency without indwelling catheters were assessed using both physical percussion and POCUS to estimate bladder volume. The examination results and subsequent voiding outcomes were recorded. The positive rates and false-negative rates of both methods were compared, and the association between spontaneous voiding ability and bladder volume, percussion findings, and perioperative variables was analyzed. Results The positive rate of POCUS was 62.00%, significantly higher than that of physical percussion at 34.00% (P = 0.01), with a false-negative rate of 28% for percussion. Within 60 minutes postoperatively, 31 patients voided spontaneously. Based on ultrasound assessment, 19 patients had bladder volumes < 150 ml, 26 had volumes between 150–600 ml, and 5 had volumes > 600 ml. Patients who voided had a median bladder volume of 300.14 ml, significantly higher than 175.81 ml in those who did not (P = 0.030). Spontaneous voiding was significantly associated with bladder volume. Other factors such as age, BMI, duration of surgery and recovery, and intraoperative and recovery fluid volumes were not significantly associated with spontaneous voiding (P > 0.05). Conclusion Postoperative spontaneous voiding ability is closely related to bladder volume. POCUS demonstrates superior sensitivity and accuracy compared to physical percussion in identifying the risk of urinary retention. Early intervention guided by POCUS provides an objective basis for postoperative catheterization decisions.