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

Area of Science:

• Urology
• Gynecology
• Pelvic Floor Disorders

Background:

• Obstructive voiding symptoms (OS) are common in women with pelvic floor disorders.
• Postvoid residual urine volume (PVR) is a key indicator of urinary retention.
• The correlation between self-reported OS and measured PVR is not well-established.

Purpose of the Study:

• To investigate the relationship between measured PVR and self-reported OS in women with pelvic floor disorders.
• To determine the diagnostic accuracy of OS for identifying elevated PVR.

Main Methods:

• Retrospective chart review of 636 patients from 2004-2005.
• Data collected included demographics, diagnoses, PVR, and Pelvic Floor Distress Inventory (PFDI-20) responses.
• Statistical analysis included Spearman's correlation and Mann-Whitney test; logistic regression identified predictive factors for elevated PVR (>150 ml).

Main Results:

• Obstructive voiding symptom items in the PFDI-20 demonstrated poor sensitivity (13-57%) and specificity (18-38%) for elevated PVR.
• Logistic regression identified age (beta = 0.04, p < 0.001) and stage ≥ III prolapse (beta = 0.78, p < 0.05) as significant predictors of elevated PVR.

Conclusions:

• Self-reported obstructive voiding symptoms have limited value in predicting elevated PVR in women with pelvic floor disorders.
• Age and advanced prolapse stage are more reliable indicators of urinary retention in this population.
• Clinical assessment should consider factors beyond self-reported symptoms for diagnosing urinary retention.