La relación entre la sensación de vaciado incompleto y un residuo posmiccional elevado

Abstract

BackgroundStudies have shown that voiding symptoms do not correlate with a high postvoid residual volume. It is important to have clinical tools that help make early and effective decisions during the initial consultation. ObjectiveTo assess the validity and degree of concordance between the sensation of incomplete voiding and high postvoid residual volume. Material and methodsCross-sectional study of patients who underwent uroflowmetry (UFM) and postvoid residual volume (PVR) measurement due to lower urinary tract symptoms, with simultaneous scoring of International Prostate Symptom Score (IPSS), the International Consultation on Incontinence Questionnaire - Female Lower Urinary Tract Symptoms (ICIQ-FLUTS) or Male Lower Urinary Tract Symptoms (ICIQ-MLUTS) during 2014-2015. We analysed the relationship between these data and the postvoid residual volume. ResultsThe study included 303 patients, 75 (24.8%) of whom were women and 228 (75.2%) of whom were men. The mean age was 60.9 years (SD, 15.8), and the mean Qmax was 14.47mL/s (SD, 9.6). Sixty (19.8%) patients had a high PVR. We detected 240 (79.2%) patients with sensations of incomplete voiding (SIV), but its presence was not associated with a high PVR in the population. For the SIV, the sensitivity, specificity, positive and negative predictive values and positive and negative likelihood ratios were 81.6%, 21.3%, 20.4%, 82.5%, 1.03 and 0.85, respectively. The area under the curve for the frequency of SIV was 0.52 (95%CI, 0.44-0.60, P=.5). The degree of concordance between SIV and high PVR was 0.014 (P=.6). In the ICIQ-MLUTS, PVR correlated with intermittence (Rho=0.132, P=.043) but not with SIV (Rho=0.09, P=.15). In the ICIQ-FLUTS, the frequency of urinary incontinence was positively correlated with PVR (Rho=0.216, P=.026). ConclusionsThe sensation of incomplete voiding is not associated with a high postvoid residual volume. Other variables such as symptom severity, urinary effort and total score for voiding symptoms can be associated with a high residual urine volume.