Abstract
Background: Women with urinary incontinence incur an increased risk of elevated postvoid residual (PVR) volume and impaired voiding efficiency (i.e., voided percentage (Void%)), but the clinical significance of these parameters remains poorly described. Further characterization of PVR and voiding efficiency may thus be useful in refining the evaluation and management of urinary incontinence. This study aims to explore possible circadian variations in PVR and Void% in older women with stress (SUI), urge (UUI) and mixed urinary incontinence (MUI). Methods: A single center prospective study which enrolled a convenience sample of 90 older women who consulted a tertiary referral hospital for urinary incontinence. Participants underwent an extensive medical interview and were hospitalized to complete a 24-h frequency-volume chart (FVC) with PVR measurement after each void (FVCPVR). Results: FVCPVR analysis demonstrated no differences in mean PVR and Void% between patients with SUI, UUI and MUI. Likewise, no daytime or nighttime differences were observed in mean PVR or Void% within or between groups. Conclusions: No evidence of circadian variation in PVR or Void% was observed in older women with SUI, UUI or MUI.
Highlights
Postvoid residual (PVR) is the volume of urine that remains in the bladder after voluntary micturition [1]
The voided percentage (Void%), defined by the International Continence Society (ICS) as the proportion of bladder content emptied [3], is even more strongly associated with peak flow rate (Qmax) [4], and may be a clinically relevant variable in the evaluation of lower urinary tract symptoms (LUTS) mediated by inefficient voiding
There is no consensus as to what volume constitutes an “elevated” postvoid residual (PVR) [5], and the specific cutoffs employed may vary across different LUTS, values of 50–100 mL are commonly recognized as the floor threshold for abnormal [6], as PVR values in excess of 100 mL are exceedingly rare in middle-aged and older women [7]
Summary
Postvoid residual (PVR) is the volume of urine that remains in the bladder after voluntary micturition [1]. Recent research of uroflowmetry parameters in women with different subtypes of urinary incontinence demonstrated high intra-individual variability in PVR volumes, but did not account for the potential influence of time-of-day on study results [10], which has been recognized as a potential confounding variable in the association between LUTS severity and PVR [11]. Women with urinary incontinence incur an increased risk of elevated postvoid residual (PVR) volume and impaired voiding efficiency (i.e., voided percentage (Void%)), but the clinical significance of these parameters remains poorly described. This study aims to explore possible circadian variations in PVR and Void% in older women with stress (SUI), urge (UUI) and mixed urinary incontinence (MUI). Results: FVCPVR analysis demonstrated no differences in mean PVR and Void% between patients with SUI, UUI and MUI. Conclusions: No evidence of circadian variation in PVR or Void% was observed in older women with SUI, UUI or MUI
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