Post-void residual urine under 150 ml does not exclude voiding dysfunction in women

Khayyami, Yasmine; Klarskov, Niels

doi:10.1007/s00192-015-2854-y

Cited by 9 publications

(6 citation statements)

References 26 publications

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“…However, the normal ranges are not agreed upon and moreover, limited as a low Qmax could also be due to BOO, whilst a low pdet@Qmax might be related to reduced outlet resistance, in the case of women with SUI. Moreover, it is possible to have DU and normal or low PVR, as recently demonstrated by Khayyami and colleagues in a small retrospective study on 20 women with voiding dysfunction [19].…”

Section: Diagnosismentioning

confidence: 79%

Detrusor Underactivity and Underactive Bladder in Women: What Is New?

Osman

Pang

Martens

et al. 2019

Curr Bladder Dysfunct Rep

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Purpose of Review Detrusor underactivity (DU) and its symptom-based correlation, the underactive bladder (UAB), are common problems encountered in urological practice. Whilst DU has been defined for many years, only recently has UAB received a formal definition and there is now accumulating literature based on this condition. In this article, we reviewed the recent literature on the aetiology, pathogenesis, diagnosis and management of DU/UAB in women. Recent Findings Detrusor underactivity is diagnosed on urodynamic studies but there still remains a lack of widely recognised and accepted diagnostic criteria. Commencing treatment based on the diagnosis of UAB, with or without a PVR measurement, is perhaps feasible due to the lower occurrence of BOO in women and specific clinical features that may distinguish this group. Prospective studies attempting to correlate UAB with the underlying DU are needed before this approach could be considered. Summary Detrusor underactivity/UAB in women requires a separate consideration from men due to the anatomical and functional differences in the lower urinary tracts between both genders and consequent differences in pathologies affecting them. The aetiology of DU remains largely unknown, but is probably multifactorial, including myogenic, neurogenic and vasculogenic factors. There remains a lack of any simple effective drug treatments, whilst apart from sacral neuromodulation for the specific subgroup with non-obstructive urinary retention, no safe and effective surgical treatment is currently available. Often, permanent or intermittent bladder drainage with a catheter is the final solution.

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Section: Diagnosismentioning

confidence: 79%

Detrusor Underactivity and Underactive Bladder in Women: What Is New?

Osman

Pang

Martens

et al. 2019

Curr Bladder Dysfunct Rep

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“…The current cut-off values for covert PUR are rather arbitrary until data on the clinical consequences of abnormal PVR are available [ 16 ]. The arbitrary cut-off of 150 ml in nonpregnant women does not exclude voiding dysfunction [ 40 ]. The Agency Health Care Research and Quality guidelines define a PVR of less than 50 ml as being indicative of adequate emptying and a PVR of more than 200 ml as inadequate emptying [ 37 ], but the range between 50 and 200 ml remains ambiguous.…”

Section: Discussionmentioning

confidence: 99%

Postpartum urinary retention: what are the sequelae? A long-term study and review of the literature

et al. 2022

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Introduction and hypothesis Postpartum urinary retention (PUR) may cause long-term urogenital tract morbidity. The incidence ranges from 0.18 to 14.6%, but the importance of prompt diagnosis and appropriate management is often underappreciated. The paucity of data on long-term outcome after PUR contributes to these drawbacks. The aim of this study was to assess long-term persistence of elevated PVR (post-void residual urine) volume after PUR. Pathophysiology, risk factors and management of PUR are reviewed. Methods In our tertiary referral urogynecology unit in the University Women’s Hospital of Bern, Switzerland, all patients who were referred for PUR were asked to participate in this study. PVR was measured sonographically every 2 days until day 15, then after 6, 12, 24 and 36 months and, if increased, the patients were instructed to perform clean intermittent self-catheterization. If retention persisted longer than the lactation period, multichannel urodynamics was performed. Results Sixty-two patients were included. The median PVR normalized at day 7. Long-term voiding disorders were found in 8.2%, 6.7%, and 4.9% after 1, 2, and 3 years respectively. Multichannel urodynamics confirmed in all patients with persisting retention an acontractile detrusor and de novo stress urinary incontinence in 4 cases. Quantile regression did not reveal any factor contributing to earlier recovery. Eighty-nine percent of the patients with PUR had operative vaginal deliveries, emphasizing the importance of this risk factor for PUR. Conclusions In most cases PUR resolves early, but voiding difficulties persist more often than previously thought, and for these patients the consequences are devastating. Obstetric awareness, early active management, and developing management strategies in the postpartum period might preclude lower urinary tract morbidity.

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“…15 Furthermore, Khayyami et al highlighted that postvoid residual urine (PVR) alone cannot exclude preoperative voiding dysfunctions underlining the role of flow measurements before surgery. 16 Although in an uncomplicated population of women with SUI, it is not demonstrated that preoperative UDS can improve the outcome of continence surgery, UDS may provide additional information when the simple office-based evaluation is not enough to identify some relevant diagnosis such as voiding dysfunction in absence of a significant post voiding residual urine, or an 'asymptomatic' DO, or a urethral sphincter deficiency. 7 As of de novo OAB, it is a known complication of mid-urethral sling surgery for the treatment of SUI.…”

Section: Discussionmentioning

confidence: 99%

Preoperative abdominal straining in uncomplicated stress urinary incontinence: is there a correlation with voiding dysfunction and de novo overactive bladder after mid-urethral sling procedures?

Iacovelli

Serati

Bianchi

et al. 2021

Therapeutic Advances in Urology

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Objectives: To evaluate the role of preoperative abdominal straining in predicting de novo overactive bladder (OAB) and voiding dysfunction in female patients undergoing suburethral taping by trans-obturator approach (TVT-O) for uncomplicated stress urinary incontinence (SUI). Methods: Data from patients who underwent TVT-O surgery for SUI were retrospectively analyzed. Inclusion criteria included: history of pure SUI. Exclusion criteria included previous surgery for urinary incontinence, pelvic radiation, pelvic surgery within the last 3 months, and anterior or apical pelvic organ prolapse (POP) ⩾ +1 cm. Voiding dysfunction has been defined through symptoms and or urodynamics (UDS) signs. Accordingly, patients were divided into group A and group B according to the presence of abdominal straining during UDS. Patients were observed clinically and with UDS at a 3-year follow-up. Results: A total of 192 patients underwent TVT-O surgery for uncomplicated SUI. Preoperative abdominal straining was identified in 60/192 patients (Group A: 31.2% vs Group B: 68.8%). Qmax was not different in the two groups (Group A: 19.5 vs Group B: 20.5 mL/s, p = 0.76). Demographics was similar for the two groups regarding age, parity. At 3-year follow-up, voiding dysfunction was reported in Group A: 9 and Group B: 8 patients ( p = 0.056), de novo OAB was significantly reported in Group A: 23 and Group B: 26 patients ( p = 0.007). Conclusion: Preoperative abdominal straining was found to be related to a significant incidence of de novo OAB. A significant correlation was not assessed for postoperative voiding dysfunction. Further studies may better define the impact of preoperative abdominal straining.

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Post-void residual urine under 150 ml does not exclude voiding dysfunction in women

Cited by 9 publications

References 26 publications

Detrusor Underactivity and Underactive Bladder in Women: What Is New?

Detrusor Underactivity and Underactive Bladder in Women: What Is New?

Postpartum urinary retention: what are the sequelae? A long-term study and review of the literature

Preoperative abdominal straining in uncomplicated stress urinary incontinence: is there a correlation with voiding dysfunction and de novo overactive bladder after mid-urethral sling procedures?

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