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Related Experiment Videos

Postvoid residual volume cannot be accurately estimated by bimanual examination

I E Nygaard1

  • 1Department of Obstetrics and Gynecology, University of Iowa College of Medicine, Iowa City 52242, USA.

International Urogynecology Journal and Pelvic Floor Dysfunction
|January 1, 1996
PubMed
Summary

Palpation is unreliable for estimating postvoid residual volume (PVR) in women with urinary incontinence. This study found low sensitivity for detecting PVR greater than 50 ml, questioning current clinical guidelines.

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Area of Science:

  • Urology
  • Gerontology
  • Women's Health

Background:

  • Urinary incontinence is a common condition affecting women.
  • Accurate assessment of postvoid residual volume (PVR) is crucial for diagnosing and managing incontinence.
  • Current guidelines suggest palpation as a method for estimating PVR.

Purpose of the Study:

  • To evaluate the accuracy of palpation for estimating postvoid residual volume (PVR) in women with urinary incontinence.
  • To compare palpation-based PVR estimates with catheterization measurements.
  • To assess the reliability of the Agency for Health Care Policy and Research (AHCPR) guideline recommendation on PVR estimation by palpation.

Main Methods:

  • Fifty consecutive women with urinary incontinence underwent PVR estimation by bimanual palpation.

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  • Immediately following palpation, PVR was measured using urinary catheterization.
  • Sensitivity and specificity of palpation were calculated against catheterization as the gold standard.

    • Main Results:

    • Only 1 out of 7 women with a positive PVR (defined as >50 ml) was correctly estimated by palpation.
    • Palpation demonstrated a sensitivity of 14% and a specificity of 67% for detecting PVR >50 ml.
    • A significant discrepancy exists between palpation estimates and catheterization measurements.

    Conclusions:

    • The study does not support the AHCPR guideline's recommendation for using palpation to estimate PVR in urinary incontinence.
    • Palpation is an insensitive method for detecting significant postvoid residual volumes in this population.
    • Further research is needed to validate palpation accuracy in specific clinical practices.