Bladder wash: a proof of concept as an alternative specimen for postmortem toxicology.

This article investigates the use of bladder wash—saline rinses of the urinary bladder collected postmortem—as an alternative specimen for toxicological analysis when urine or blood samples are unavailable. Through comprehensive drug and alcohol testing on paired bladder wash, urine, blood, and vitreous humor samples from authentic forensic cases, the study found that bladder wash analysis demonstrates high specificity (>99%) and good sensitivity (up to 89% after correction for drug families) comparable to urine testing, though sensitivity is generally lower than blood analysis. The bladder wash method detected numerous drugs, including opioids, amphetamines, and cocaine metabolites, in cases lacking other biological specimens, providing valuable forensic information. The study concludes that bladder wash collection is a simple, minimally invasive procedure that can be integrated into routine urine testing protocols, offering forensic toxicologists and pathologists a useful alternative specimen in postmortem investigations.