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Clinical Significance of Postvoid Residual Volume in Older Ambulatory Women
Author(s) -
Huang Alison J.,
Brown Jeanette S.,
Boyko Edward J.,
Moore Elya E.,
Scholes Delia,
Walter Louise C.,
Lin Feng,
Vittinghoff Eric,
Fihn Stephan D.
Publication year - 2011
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2011.03511.x
Subject(s) - medicine , ambulatory , confidence interval , odds ratio , prospective cohort study , urination , urinary incontinence , lower urinary tract symptoms , urinary system , urology , prostate , cancer
OBJECTIVES: To examine the prevalence, natural history, and clinical significance of high postvoid residual (PVR) volume in ambulatory older women. DESIGN: Prospective cohort study. SETTING: Group health plan in Washington state. PARTICIPANTS: Nine hundred eighty‐seven ambulatory women aged 55 to 75. MEASUREMENTS: PVR was measured using bladder ultrasonography at baseline, 1 year, and 2 years. Participants completed questionnaires about urinary symptoms and provided urine samples for microbiological evaluation. RESULTS: Of the 987 participants, 79% had a PVR less than 50 mL, 10% of 50 to 99 mL, 6% of 100 to 199 mL, and 5% of 200 mL or greater at baseline. Of women with a PVR less than 50 mL, 66% reported at least one urinary symptom at baseline. Of women with a PVR of 200 mL or greater, 27% reported no significant symptoms at baseline. In adjusted analyses using data from all study visits, women with a PVR of 100 mL or greater were more likely to report urinating more than eight times during the day (odds ratio (OR)=1.42, 95% confidence interval (CI)=1.07–1.87), and women with a PVR of 200 mL or greater were more likely to report weekly urgency incontinence (OR=1.50, 95% CI=1.03–2.18) than those with a PVR less than 50 mL. High PVR was not associated with greater risk of stress incontinence, nocturnal frequency, or urinary tract infection in adjusted analyses. Forty‐six percent of those with a PVR of 200 mL or greater and 63% of those with a PVR of 100 to 199 mL at baseline had a PVR less than 50 mL at 2 years. CONCLUSION: More than 10% of ambulatory older women may have a PVR of 100 mL or greater, which is associated with greater risk of some urinary symptoms, but many with high PVR are asymptomatic, and high PVR frequently resolves within 2 years. Symptom‐guided management of urinary symptoms may be more appropriate than PVR‐guided management in this population.