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Elevated Postvoid Residual Urine Volume: Identifying Risk Factors and Predicting Resolution in Women With Pelvic Organ Prolapse

Ulrich, Amanda, MD*; Davis, Patricia, MD; Propst, Katie, MD; O'Sullivan, David M., PhD§; Tulikangas, Paul, MD

Female Pelvic Medicine & Reconstructive Surgery: November/December 2018 - Volume 24 - Issue 6 - p 444–448
doi: 10.1097/SPV.0000000000000471
Original Articles

Objectives This study aims to identify risk factors for elevated preoperative postvoid residual (PVR) and persistently elevated postoperative PVR and to evaluate the resolution rate of elevated PVR urine volume in patients undergoing reconstructive surgery for pelvic organ prolapse (POP).

Methods This was a retrospective cohort study comparing 50 women with elevated preoperative PVR (≥100 mL) and 50 women with normal PVR (<100 mL). Preoperative demographic, physical examination, urodynamic data, type of surgery performed, and postoperative trial of void data were collected. Variables were evaluated for association with elevated PVR using Student t test or Mann-Whitney U test, and χ2 or Fisher exact test.

Results The elevated PVR cohort was older (65.5 ± 13.3 vs 60.6 ± 10.1 years, P = 0.04). The cohorts did not differ by body mass index, parity, number of cesarean deliveries, prior hysterectomy, incontinence, prolapse surgery, menopausal status, hormone replacement therapy, history of recurrent urinary tract infections, diabetes mellitus, or maximum bladder capacity. Most patients had preoperative anterior prolapse stage 2 or 3. Complaints of incontinence, incomplete bladder emptying, and overactive bladder did not differ between groups. Performed Surgical procedures, cystoscopy findings, and rate of postoperative trial of void failures did not differ between groups. One patient per cohort learned clean intermittent self-catheterization for persistently elevated PVR.

Conclusions All women undergoing surgery for POP had postoperative resolution of elevated PVR. Patients with nonneurogenic-elevated PVR can be reassured that bladder emptying will improve after surgical repair of POP.

From the *Department of Obstetrics and Gynecology, University of Connecticut, Farmington;

Women's Comprehensive Health Care;

Female Pelvic Medicine and Reconstructive Surgery, Department of Women's Health, and

§Research Administration, Hartford Hospital, Hartford, CT.

Correspondence: Amanda Ulrich, MD, Department of Obstetrics and Gynecology, University of Connecticut, 263 Farmington Ave, Farmington, CT 06030-2947. E-mail: aulrich@uchc.edu.

This study has received funding from the Division of Urogynecology at Hartford Hospital.

The authors have declared that there are no conflicts of interest.

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.