Clinical Relevance and Symptom Burden Associated with Elevated Post-void Residual Urine in Women: A Cohort Study

Urinary retention, which is defined as an elevated post-void residual (PVR) volume, is a common finding in the field of urogynaecology. However, data on its clinical relevance and the associated symptom burden experienced by women are limited. This study aimed to evaluate symptoms associated with elevated PVR, current drainage strategies and the impact of bladder drainage on clinical burden.

This single-centre, retrospective observational cohort study included women presenting with a PVR of over 100 mL between January 2020 and December 2022. Demographic and clinical data were recorded. Symptom burden was assessed using a visual analogue scale (VAS 0-10) at baseline and after 6 months. Treatment strategies and outcomes were analysed.

A total of 239 women (mean age 61.2 years; range 23-92) were included in the study. The median PVR was 290 mL (range 170-2310 mL). The most common presenting symptom was recurrent urinary tract infection (57%), followed by mixed urinary incontinence (23%), overactive bladder (15%) and stress urinary incontinence (4%). Pharmacological treatment resulted in an objective improvement in 18% of patients. Intermittent self-catheterisation was required in 88% of cases. The mean VAS score improved from 7.2 at baseline to 1.7 at follow-up. A clinically relevant improvement (a reduction in VAS of at least 5 points) was observed in 90% of patients. Subgroup analysis suggested lower improvement rates in women aged ≥ 60 years.

Elevated PVR in women is associated with a substantial symptom burden. Bladder drainage, particularly intermittent self-catheterisation, is associated with significant symptom improvement. However, treatment response may be reduced in older patients.