Sensation of incomplete bladder emptying in women: Lack of correlation to an elevated post‐void residual

Abstract

Introduction/Background: Sensation of incomplete bladder emptying (SIBE) has been shown to be correlated with an elevated post-void residual (PVR) in men, however, the significance of this symptom and whether it correlates with an elevated PVR in women is less clear. In this study, we assessed if SIBE in women is correlated with an elevated PVR and determined the relationship of SIBE to other lower urinary tract symptoms. Methods/Materials: Women ages ≥18 with lower urinary tract symptoms were eligible. SIBE was defined by a response "sometimes", "most of the time", or "all of the time" to the question "How often do you feel that your bladder has not emptied properly after you have urinated?" on the International Consultation on Incontinence Questionnaire. Frequency and bother of other lower urinary tract symptoms were also assessed to compare their relationship to SIBE. Elevated PVR was defined as ≥100 ml via ultrasound. Results: We prospectively evaluated 95 women, 59% of whom reported SIBE.Compared to women without SIBE, women with SIBE reported more urinary hesitancy (51% vs. 18%, p = 0.002), intermittency (56% vs. 16%, p < 0.001), weak stream (36% vs. 5%, p < 0.001), dysuria (29% vs. 5%, p = 0.004), and straining (25% vs 5%, p = 0.013). However, there was no difference in elevated PVRs between women with and without SIBE [5/56, 9% vs. 4/39, 10%, (p = 0.99)]. All women, regardless of SIBE, reported higher bother from storage and incontinence symptoms versus voiding symptoms with no difference in overall bother scores.Conclusion: SIBE is a common complaint in women with lower urinary tract symptoms. While women with SIBE reported more voiding symptoms, they were more bothered by storage symptoms. Importantly, most of these women emptied their bladder well and were not more likely to have an elevated PVR than women without SIBE.

Overactive Bladder Patients With and Without Urgency Incontinence: A Spectrum of One Condition or Different Phenotypes?

“…OAB-dry patients more commonly experienced a feeling of incomplete bladder emptying, straining to begin urination, and bladder pain; these symptoms, in conjunction with urinary urgency, were significantly associated with the elevated symptomatic bother. In agreement with previously published work, the perceived symptom of incomplete emptying did not correlate with actual urinary retention as there was no relation between subjective obstructive complaints and objective findings 13 …”

“…In agreement with previously published work, the perceived symptom of incomplete emptying did not correlate with actual urinary retention as there was no relation between subjective obstructive complaints and objective findings. 13 It has been hypothesized across the literature 10 that OAB-wet is a more severe form of OAB-dry, with OAB-wet having more detrusor overactivity on urodynamic testing. The presence of distinct patterns of symptoms in OAB-dry patients, some of which are significantly more severe than in OAB-wet, speaks against this assumption.…”

Sacral Tarlov cysts: Neurophysiology abnormalities and correlation with pelvic sensory and visceral symptoms

“…Furthermore, changes were more often seen unilaterally and damage to a single nerve root or even several nerve roots unilaterally, may not result in significant dysfunction of the detrusor which receives its innervation bilaterally. The poor correlation between voiding symptoms and urodynamics findings could be multifactorial including partial involvement of the sacral roots and lack of a gold standard for defining detrusor underactivity in women [36,37]. Confounding factors such as medications (especially use of opiates), age and concomitant comorbidities such as pelvic organ prolapse could have also contributed to voiding dysfunction.…”