Bladder palpation is a non-invasive physical examination where a healthcare provider gently feels the abdomen to assess the bladder’s size, shape, and consistency. It serves as a preliminary diagnostic tool, often employed for quick initial assessments.
Understanding Bladder Location and Normal Sensation
The bladder is nestled within the pelvic cavity, directly behind the pubic bone. In individuals assigned male at birth, it rests between the pubic bone and the rectum. In those assigned female at birth, it is positioned in front of the vagina and uterus.
An empty bladder is typically soft and cannot be felt during palpation. As the bladder fills, it expands and becomes slightly firm, though it remains difficult to distinguish unless significantly distended. A healthy adult bladder can hold approximately 300 to 600 milliliters of urine before the sensation to void arises. Bladder sensation involves pressure and stretch receptors within the bladder wall, which relay information about its fullness.
Why Bladder Palpation is Performed
Bladder palpation is performed for several clinical reasons, including assessing for urinary retention (the inability to empty the bladder). It helps evaluate the degree of bladder fullness and can be used to investigate causes of lower abdominal pain or tenderness. Providers also use this technique to check for any abnormal masses.
This examination offers a rapid initial assessment, particularly when advanced diagnostic equipment is limited. The information obtained helps guide further diagnostic steps and informs patient care decisions. It provides immediate insights that can be followed up with more detailed investigations if necessary.
How to Palpate the Bladder and What to Look For
To perform bladder palpation, the patient should lie in a supine position with knees bent to relax abdominal muscles. The examiner places their hand just above the pubic bone, moving downwards from the navel toward the pelvis. The technique involves applying light pressure with fingertips initially, followed by deeper pressure if needed to assess the bladder’s state.
A distended bladder feels firm, smooth, and rounded, often described as an oval-shaped mass. In cases of significant distension, the upper border of the bladder can extend as high as the umbilicus. Applying pressure to a distended bladder can often worsen the patient’s urge to urinate or cause discomfort.
Caution is advised in situations like pregnancy, the presence of tumors, or an active infection or stones. If a patient experiences severe pain, inability to urinate, persistent tenderness, or a mass is felt, seeking professional medical attention is important. These findings, along with symptoms like leaking urine, a constant urgent need to urinate, or a very weak stream, indicate a need for further medical evaluation, as the inability to empty the bladder can lead to long-term health issues.