Clinical Significance of Postvoid Residual Volume in Older Ambulatory Women

• Autores: Alison J. Huang, Jeanette S. Brown, Edward J. Boyko, Elya E. Moore, Delia Scholes, Louise C. Walter, Feng Lin, Eric Vittinghoff, Stephan D. Fihn
• Localización: Journal of the American Geriatrics Society, ISSN 0002-8614, Vol. 59, Nº. 8, 2011, págs. 1452-1458
• Idioma: inglés
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• Resumen

  • OBJECTIVES: To examine the prevalence, natural history, and clinical significance of high postvoid residual (PVR) volume in ambulatory older women.

    DESIGN: Prospective cohort study.

    SETTING: Group health plan in Washington state.

    PARTICIPANTS: Nine hundred eighty-seven ambulatory women aged 55 to 75.

    MEASUREMENTS: PVR was measured using bladder ultrasonography at baseline, 1 year, and 2 years. Participants completed questionnaires about urinary symptoms and provided urine samples for microbiological evaluation.

    RESULTS: Of the 987 participants, 79% had a PVR less than 50 mL, 10% of 50 to 99 mL, 6% of 100 to 199 mL, and 5% of 200 mL or greater at baseline. Of women with a PVR less than 50 mL, 66% reported at least one urinary symptom at baseline. Of women with a PVR of 200 mL or greater, 27% reported no significant symptoms at baseline. In adjusted analyses using data from all study visits, women with a PVR of 100 mL or greater were more likely to report urinating more than eight times during the day (odds ratio (OR)=1.42, 95% confidence interval (CI)=1.07�1.87), and women with a PVR of 200 mL or greater were more likely to report weekly urgency incontinence (OR=1.50, 95% CI=1.03�2.18) than those with a PVR less than 50 mL. High PVR was not associated with greater risk of stress incontinence, nocturnal frequency, or urinary tract infection in adjusted analyses. Forty-six percent of those with a PVR of 200 mL or greater and 63% of those with a PVR of 100 to 199 mL at baseline had a PVR less than 50 mL at 2 years.

    CONCLUSION: More than 10% of ambulatory older women may have a PVR of 100 mL or greater, which is associated with greater risk of some urinary symptoms, but many with high PVR are asymptomatic, and high PVR frequently resolves within 2 years. Symptom-guided management of urinary symptoms may be more appropriate than PVR-guided management in this population.