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Immediate Postvoid Residual Volumes in Women With Symptoms of Pelvic Floor Dysfunction

From ¹St. Vincent’s Clinic and ²St. Vincent’s Hospital, Darlinghurst, N.S.W., Australia; and the ³National Centre in HIV Epidemiology & Clinical Research, University of New South Wales, Kensington, N.S.W., Australia.

OBJECTIVE: To estimate the prevalence and clinical and urodynamic associations of postvoid residual volumes (PVRs), measured immediately after micturition, in women with symptoms of pelvic floor dysfunction.

METHODS: The patients were 1,140 women presenting consecutively for their initial urogynecological assessment, including urodynamics. They were studied prospectively. Measurement of PVRs was by transvaginal ultrasonography within 60 seconds of micturition. After the estimation of prevalence of the different levels of PVR, an appropriate upper limit of normal PVR was estimated and associations then were sought for PVRs with a wide range of clinical and urodynamic parameters.

RESULTS: The overall prevalence of PVRs was 76% at 0–10 mL, 5% at 11–30 mL, 5% at 31–50 mL, 8% at 51–100 mL, and 6% at more than 100 mL. Thus, using transvaginal ultrasonography, 81% of immediate PVRs were 30 mL or less. Higher than 30 mL, a significantly increased prevalence of women presenting with recurrent urinary tract infections (UTIs) was noted (P<.001). The level of 30 mL was deemed to be an appropriate upper limit of normal PVR. The prevalence of PVRs higher than 30 mL increased significantly with age (P<.001) and higher grades of prolapse (P<.001). There was a significant inverse relation of PVRs higher than 30 mL to the symptom of stress incontinence (P=.018) and the diagnosis of urodynamic stress incontinence (P<.001).

CONCLUSION: Eighty-one percent of immediate PVRs (95% confidence interval 79–84%) in symptomatic women are 30 mL or less. Postvoid residual volumes higher than this level are significantly associated with increasing age, higher grades of prolapse, and an increased prevalence of recurrent UTIs.

LEVEL OF EVIDENCE: II