Obstructive voiding symptoms are not predictive of elevated postvoid residual urine volumes

Abstract

The aim of this study is to explore the relationship between measured postvoid residual urine volumes (PVR) and self-reported bother from obstructive voiding symptoms (OS) using a retrospective chart review of patients presenting to our clinic from 2004 to 2005. Demographic, primary clinical diagnoses, PVR, and responses to the short form of the Pelvic Floor Distress Inventory (PFDI-20) were recorded. We considered a PVR > 150 ml to be elevated or consistent with urinary retention. We used Spearman's for correlations and Mann-Whitney test for independent groups. Six hundred thirty-six patients were included in the study. Individual PFDI-20 items, which inquire about obstructive voiding symptoms, had poor sensitivity (13-57%) and specificity (18-38%) for elevated PVR. Using logistic regression, age (beta = 0.04, p < 0.001) and stage > or = III prolapse (beta = 0.78, p < 0.05) were predictive factors for elevated PVR. Obstructive voiding symptoms have poor sensitivity and specificity for elevated PVR in women with pelvic floor disorders.

Urodynamic findings in women with pelvic organ prolapse and obstructive voiding symptoms

“…Most cases of objective voiding dysfunction were attributed to impaired detrusor contractility. Two other reports addressed the issue of whether obstructive voiding symptoms in women with POP correlated with objective bladder outflow tract obstruction, and found no such association [15,16]. Similarly, the present study found no correlation between subjective voiding difficulty and objective urodynamic bladder outflow tract obstruction, indicating that the latter should be ruled out in all women with advanced POP, irrespective of the presence or absence of the former.…”

Risk Factors for Incomplete Bladder Emptying After Midurethral Sling

“…This differs from smaller studies supporting the use of such testing, 9 but is similar to findings reported by Lowenstein et al using the obstructive portion of the Pelvic Floor Distress Inventory. 10 …”

Effect of Aging on Storage and Voiding Function in Women with Stress Predominant Urinary Incontinence

“…Women often present with symptoms commonly associated with voiding dysfunction such as a slow urine stream, straining to void, a feeling of incomplete bladder emptying, need to re-void and position-dependent micturition. In general, voiding symptoms have poor sensitivity and specificity for predicting an elevated post-void residual (PVR) in women (1, 2) and are poorly correlated to urodynamic evidence of obstruction (3-5). …”