Person- or caregiver-directed handheld bladder ultrasound as an adjunct to intermittent catheterization in individuals with spinal cord injury: A pilot feasibility study

Objectives To evaluate the feasibility of person- or caregiver-directed handheld ultrasound for bladder volume estimation in individuals with spinal cord injury (SCI) performing clean intermittent catheterization (CIC), and to assess agreement with catheterized volumes and effects on catheterization frequency.Design Prospective pilot feasibility study of community-dwelling individuals with SCI using CIC.Setting Outpatient SCI center.Participants Persons with SCI who manage their bladder with CIC.Interventions Participants and caregivers received standardized training on the Butterfly iQ+™ handheld ultrasound device. After a baseline period of usual time-based catheterization, participants used ultrasound-guided bladder assessment during a structured intervention phase and an optional self-directed phase.Outcome Measures Feasibility, usability, and acceptability of handheld bladder ultrasound use; agreement between ultrasound-estimated and catheterized bladder volumes; and catheterization frequency.Results Ten participants were enrolled; nine had complete data for analysis. All achieved competency in ultrasound use within one hour of training. Ultrasound-estimated bladder volumes showed reasonable agreement with catheterized volumes, generally within 100 mL. Catheterization frequency decreased during the ultrasound-guided phase compared with baseline (5.5 ± 1.5 vs. 4.5 ± 1.4 catheterizations/day; P = 0.017), without changes in catheterized volumes or fluid intake. Participants who retained the device (n = 6) also demonstrated reduced catheterization frequency (5.9 ± 1.4 to 4.6 ± 1.6 per day; P = 0.027). Usability ratings were favorable, though portability and willingness to purchase the device varied.Conclusions Handheld bladder ultrasound using a smartphone- or tablet-connected platform is feasible and may reduce unnecessary catheterization in individuals with SCI performing CIC. Larger studies are needed to evaluate sustained use and clinical impact.