Postvoid Residual Thresholds Used to Define Chronic Urinary Retention: A Systematic Review.

Area of Science:

• Urology
• Nephrology
• Diagnostic criteria

Background:

• Chronic urinary retention (CUR) is a significant urological condition.
• Current diagnosis relies on postvoid residual (PVR) volumes, but lacks a standardized threshold.
• Inconsistent definitions hinder clinical decision-making and research comparability.

Purpose of the Study:

• To systematically review how CUR is defined in existing literature.
• To analyze reported PVR thresholds used for CUR diagnosis.
• To identify consensus or lack thereof in CUR diagnostic criteria.

Main Methods:

• Systematic-narrative review of five databases (MEDLINE, EMBASE, CENTRAL, Web of Science, Google Scholar).
• Included randomized trials, observational studies, and systematic reviews defining CUR via PVR thresholds in adults.
• Searched in August 2022 and December 2025, screening 4588 abstracts for 14 included studies.

Main Results:

• PVR thresholds for CUR ranged from 150 ml to 1000 ml, with 300 ml being most common (10 studies).
• Eleven studies focused on CUR secondary to benign prostatic hyperplasia.
• Significant heterogeneity observed in study populations, voiding status reporting, and PVR measurement methods (ultrasound/bladder scan).

Conclusions:

• The literature exhibits considerable inconsistency in defining CUR and its PVR thresholds.
• Limited and heterogeneous evidence prevents establishing a single, definitive PVR threshold for CUR.
• Further research is needed to standardize CUR diagnostic criteria.