Volume In Women Research Articles

THE CAUSE AND NATURAL HISTORY OF ISOLATED URINARY RETENTION IN YOUNG WOMEN

Using a questionnaire mailed to patients we evaluated the course and natural history of urinary retention in women, of which the cause is attributed to electromyography abnormality of the striated urethral sphincter. Previously urinary retention in young women has often been considered to be due to multiple sclerosis or a manifestation of a psychogenic disorder. A questionnaire was mailed to 216 women with abnormal sphincter electromyography and urinary retention. Of the 112 responses we analyzed the 91 from those who had been in complete urinary retention. Mean patient age at the onset of complete retention was 27.7 years (range 10 to 50). No patients had neurological features indicating a cauda equina lesion or central demyelination and none had progressed to features of a general neurological disorder. Mean maximum bladder capacity at the initial episode of complete retention was 1,208 ml. Of the women 65% reported an event that had apparently precipitated urinary retention, most commonly a gynecologic surgical procedure using general anesthesia. Sacral neuromodulation was the only therapeutic intervention that restored voiding. The concept of an organic cause of urinary retention in otherwise healthy young women has considerable importance in terms of correct management. Neurological investigation in these women does not reveal underlying neurological disease. It is thought that this disorder is due to a primary failure of relaxation of the striated urethral sphincter.

Measurement of upper extremity volume in women after axillary dissection for breast cancer

Megens AM, Harris SR, Kim-Sing C, McKenzie DC. Measurement of upper extremity volume in women after axillary dissection for breast cancer. Arch Phys Med Rehabil 2001;82:1639-44. Objective: To determine if 2 methods of calculating upper extremity volume (using arm circumferences) can substitute for water displacement volumetry. Design: Interrater and test-retest reliability and limits of agreement for volume measures. Setting: University. Participants: Twenty-five women at risk for lymphedema who had undergone axillary lymph node dissection surgery for breast cancer. Interventions: Circumference and volume measurements of both upper extremities were taken by 2 physical therapists at an initial visit and by 1 of the therapists 1 week later. Main Outcome Measures: Intraclass correlation coefficients (ICCs) were calculated to analyze measurement reliability. Pearson's product-moment correlation coefficient (r) was used to evaluate the relationship between volumetry and calculated truncated cone volumes. Limits of agreement were calculated to determine the level of agreement between the 2 measurement methods. Results: Interrater and test-retest reliability ICCs for circumferential and volumetric data were .99 and .99, respectively. Pearson's r values were .93 and .97 for the single truncated cone and the summed truncated cone volume calculations, respectively. Limits of agreement (mean ± 2 standard deviations) were −52 ± 334mL and −40 ± 234mL, respectively, between volumetry and the single truncated cone and summed truncated cone calculations. Conclusions: Calculated and volumetric measurements in this population are both reliable and closely related, but do not agree with each another, and thus should not be used interchangeably. © 2001 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

Risk factors for an elevated postvoid residual urine volume in women with symptoms of urinary urgency, frequency and urge incontience.

The aim of this study was to identify factors in patients with symptoms of urgency/frequency or urge incontinence that predict that the postvoid residual urine volume (PVR) will be elevated. A restrospective chart review was carried out of all patients new to our urogynecology practice between June 1998 and May 1999, with symptoms of urgency, frequency and/or urge incontinence. Demographic variables, symptoms and physical findings were correlated with the presence of an elevated PVR (>100 ml) using logistic regression analysis. An elevated PVR was found in 10% (33/336) of patients with urge incontinence (UI). and in 5% (3/57) of patients with urgency/frequency without UI. In patients with UI the presence of pelvic organ prolapse (POP) > or = stage II, symptoms of voiding difficulty and the absence of the symptom of stress incontinence, predicted 82% of patients with an elevated PVR.

The contribution of reduced peak accrual of bone and age-related bone loss to osteoporosis at the spine and hip: insights from the daughters of women with vertebral or hip fractures.

The genetic hypothesis states that a daughter will resemble her mother by about 50% in a given trait because she shares, on average, half her genes. We used this trait resemblance in mothers and daughters to determine whether abnormalities in volumetric bone mineral density (vBMD) or bone size in women with fractures originate in growth or aging. vBMD and volume of the third lumbar vertebra and femoral neck were estimated using posteroanterior (PA) scanning by dual-energy X-ray absorptiometry (DXA). Vertebral volume was estimated as (scan area)(3/2) and femoral neck volume was pi* (width/2)(2)* height. vBMD was bone mineral content (BMC)/volume. The data were expressed as age-specific SD or Z scores (mean +/- SEM). Vertebral vBMD was reduced by -0.98 +/- 0.14 SD (p < 0.001) in 34 women with vertebral fractures, and by -0.36 +/- 0.13 SD (p < 0.05) in their 44 premenopausal daughters. The vBMD deficit in the daughters (relative to age-matched controls) was no different from one-half their mothers' deficit (relative to their age-matched controls). Vertebral volume was reduced in the women with vertebral fractures relative to age-matched controls (-0.77 +/- 0.15 SD; p < 0.001), but not in their daughters (-0.17 +/- 0.13 SD, NS). The 31 women with hip fractures and their 41 premenopausal daughters had no deficits in vertebral volume or vBMD. Femoral neck vBMD was reduced in the women with hip fractures (-1.24 +/- 0.12 SD; p < 0.001) but not in their daughters (-0.17 +/- 0.13 SD, NS). Femoral neck volume was increased by 0.98 +/- 0.30 SD (p < 0.05) in women with hip fractures (relative to age-matched controls) and by 0.54 +/- 0.14 SD (p < 0.001) in their daughters (relative to age-matched controls); that is, about one-half that of their mothers. We propose that women with vertebral fractures have reduced vertebral vBMD because of, in large part, reduced accrual of bone during growth (because the deficit in their daughters was almost one-half their mothers' deficit); reduced vertebral volume in women with vertebral fractures is caused by reduced periosteal apposition during aging (because their daughters have no deficit in vertebral volume). Women with hip fractures have reduced vBMD because of age-related bone loss (because their daughters have no deficit in vBMD) but the increased femoral neck volume is growth related (because their daughters' femoral neck size is increased by one-half as much). The pathogenesis of bone fragility at the axial and appendicular skeleton is heterogeneous and has its origins in growth and aging.

Administration of somatostatin analogue reduces uterine and myoma volume in women with uterine leiomyomata

Uterine leiomyomata are the most common benign tumors in women, occurring in 20%–25% of women during their reproductive years. The etiology of myomas has not been fully elucidated. Growth of leiomyomas is promoted by various factors. Hypoestrogenism, which occurs after the postmenopause and during therapy with gonadotropin-releasing hormone (GnRH) agonist, reduces the size of leiomyomas; this observation indicates that the tumor is estrogen dependent (1). Similarly, marked regression of leiomyomas after therapy with the potent antiprogestin RU486 indicates a probable stimulatory effect of progesterone on the tumor (2). Increasing evidence shows that growth factors may play a role in the generation or growth of this tumor.

Reduced dorsal and orbital prefrontal gray matter volumes in schizophrenia.

Converging neuroanatomic, neurophysiological, and neurobehavioral evidence implicate prefrontal subregions in schizophrenia. Neuroanatomic studies with magnetic resonance (MR) imaging enable regional volume parcellation. Inconsistent reports may relate to variable methods and small samples. We attempted to resolve volume differences within sectors of the prefrontal lobe in a large sample, relating volumes to clinical and neurocognitive features. Magnetic resonance imaging was performed in 70 patients with schizophrenia (40 men and 30 women; 29 neuroleptic naive and 41 previously treated) and 81 healthy controls (34 men and 47 women). Gray and white matter volumes of the dorsolateral, dorsomedial, orbitolateral, and orbitomedial prefrontal cortex were quantified. Symptoms, functioning, and neurocognition were assessed concurrently. Reduced prefrontal gray matter volume was observed in patients. The reduction was evident for the dorsolateral area in men (9%) and women (11%), for the dorsomedial area only in men (9%), and for orbital regions only in women (23% and 10% for lateral and medial, respectively). The reduction of orbital volume in women was associated with poorer premorbid functioning, more severe negative symptoms, and depression. Volume of dorsal cortex was positively associated with better performance on abstraction and attention tasks across all groups. Schizophrenia is associated with reduced gray matter volume in prefrontal cortex, which affects men and women in the dorsolateral sector. The effects are moderated by sex for dorsomedial and orbital regions and are related to symptom severity and cognitive function. This is not a by-product of treatment, since the differences are evident in neuroleptic-naive patients.

Coexistent hemoconcentration and hypoosmolality during superovulation and in severe ovarian hyperstimulation syndrome: a volume homeostasis paradox

Objective: To investigate the concomitant time courses of the changes in osmolality and calculated blood volume during the genesis of ovarian hyperstimulation syndrome (OHSS). Design: Prospective longitudinal study. Setting: IVF-ET program in a university-based assisted reproductive technology center. Patient(s): Thirty women undergoing superovulation for IVF-ET. Intervention(s): Blood and urine samples were obtained on seven occasions from the start of FSH stimulation until a pregnancy test. Five women with severe OHSS had daily blood and urine tests during hospitalization. Main Outcome Measure(s): Changes in serum and urine osmolality, serum electrolytes, albumin, hemoglobin, and hematocrit. Result(s): Blood volume in women with OHSS decreased significantly by 20% from days hCG +2 to +4, followed by a sustained increase of 30% above baseline from days hCG +8 to +12. There was no statistically significant change in blood volume in women without OHSS. There was a sharp decrease in serum osmolality in women without OHSS between days 0 and hCG +2, which recovered toward baseline from day 4 after hCG. In women with OHSS, there was an unexpected increase in osmolality of 6 mOsm/kg between days hCG −2 and 0, followed by a decrease of 8 mOsm/kg by day hCG +2; this was sustained until day hCG +12. Patients with OHSS demonstrated a concentration and dilution of their urine during the acute and recovery phases of the syndrome, respectively, despite persistence of the hypoosmolar state. Conclusion(s): Decreased osmolality in severe OHSS is maintained despite significant decreases and increases in blood volume, suggestive of fundamental alterations in osmoregulation.

Ovarian Volume Related to Age

Objective. The goal of this study was to determine the relationship of ovarian volume to age, height, and weight in women undergoing transvaginal sonography.Methods. Thirteen thousand nine hundred sixty-three women 25–91 years of age undergoing annual transvaginal sonography as part of the University of Kentucky Ovarian Cancer Screening Program were the subjects for this investigation. Each ovary was measured in three dimensions, and ovarian volume was calculated using the prolate ellipsoid formula (L × H × W × 0.523). Mean ovarian volume according to age was calculated for each decade of life.Results. Data were obtained from 58,673 observations of ovarian volume. Mean ovarian volume was 6.6 ± 0.19 cm3 in women less than 30 years of age; 6.1 ± 0.06 cm3 in women 30–39; 4.8 ± 0.03 cm3 in women 40–49; 2.6 ± 0.01 cm3 in women 50–59; 2.1 ± 0.01 cm3 in women 60–69; and 1.8 ± 0.08 cm3 in women ≥70. Mean ovarian volume was 4.9 ± 0.03 cm3 in premenopausal women and 2.2 ± 0.01 cm3 in postmenopausal women (P < 0.001). The use of exogenous estrogens was associated with a significant reduction in ovarian volume in women 40–59 years of age, but not in women ≥ 60. Ovarian volume was unrelated to patient weight but was greater in tall women (>68 in.) than in short women (<58 in.).Conclusion. There is a statistically significant decrease in ovarian volume with each decade of life from age 30 to age 70. Mean ovarian volume in premenopausal women is significantly greater than that in postmenopausal women. The upper limit of normal for ovarian volume is 20 cm3 in premenopausal women and 10 cm3 in postmenopausal women.

Deep endometriosis conundrum: evidence in favor of a peritoneal origin

Objective: To determine whether the depth and volume of the pouch of Douglas differs in patients with endometriosis with and without deep lesions and to compare them with subjects with a healthy pelvis or with diseases other than endometriosis. Design: Prospective, comparative study. Setting: Tertiary care and referral center for patients with endometriosis. Patient(s): Women undergoing laparoscopy for infertility, pelvic pain, or adnexal anomalies (deep endometriotic rectovaginal lesions in 16 cases, endometriosis without deep lesions in 127 cases, miscellaneous anomalies in 35 cases, and normal pelvis in 26 cases). Intervention(s): Douglas pouch depth measurement from the upper border of uterosacral ligaments to its base with a calibrated probe and volume assessment by a fluid-filling technique. Main Outcome Measure(s): Douglas pouch depth and volume. Result(s): Mean (±SD) Douglas pouch depth and volume measurements were 3.6 ± 1.6 cm and 41.6 ± 19.3 mL in women with deep endometriosis, 5.3 ± 0.8 cm and 67.2 ± 18.1 mL in those with peritoneal and ovarian lesions only, 5.2 ± 0.9 cm and 67.6 ± 12.6 mL in those with miscellaneous conditions, and 5.5 ± 0.8 cm and 65.8 ± 10.9 mL in those with normal pelvis. Conclusion(s): Reduced Douglas pouch depth and volume in women with deep endometriosis suggest that such lesions develop not in the rectovaginal septum but intraperitoneally and that burial by anterior rectal wall adhesions creates a false bottom, giving an erroneous impression of extraperitoneal origin.

Reading between the lines. Gender and politics in Greek reading schemes

Attempts to show the results of an example of an educational policy on gender equality in a very specific aspect of the Greek educational process. Briefly covers the historical background on equality, the position of women in Greece from 1975 to 1985 and the centralized method of setting primary school books and course content. Shows how gender roles have changed within the prescribed books but questions to what success this has been. Suggests that the changes, whilst an improvement, have actually lessened the volume of women within the material and failed to define a role in which their potential has been fulfilled.

Imaging the urethral sphincter with three-dimensional ultrasound

Objective: To image the striated urethral sphincter (rhabdosphincter) using three-dimensional ultrasound and to compare its size in women with genuine stress incontinence and continent controls. Methods: Women with no previous continence or prolapse surgery had transvaginal sonography using a 7.5-MHz mechanical sector endoprobe with real-time and three-dimensional facilities. Three perpendicular planes were displayed simultaneously on the screen. Manipulation of the stored images allowed detailed morphologic assessment of the urethra at different levels using several parallel cross-sectional planes along its length. The length, thickness, and volume of the rhabdosphincter were measured. Results: Forty-six women with genuine stress incontinence (27–73 years, mean 48) and 48 continent controls (23–76 years, mean 49) were studied. In the transverse plane, the inner part of the urethra, which consists of urothelium and smooth muscle, appeared hyperechogenic compared with the outer hypoechogenic ring of striated muscle. The two groups studied were not different in age and parity. Women with genuine stress incontinence, compared with continent controls, had a significantly shorter (mean ± standard deviation 16.9 ± 1.9 mm compared with 19.2 ± 3.6 mm; P = .001), thinner (2.1 ± 0.5 mm compared with 2.5 ± 0.4 mm; P < .001), and smaller volume (0.8 ± 0.2 mL compared with 1.2 ± 0.2 mm; P < .001) of the striated urethral sphincter. There was a close correlation between the urethral sphincter volume and the degree of incontinence assessed on videocystourethrography ( r = −.65, P < .001). Conclusion: Three-dimensional ultrasound allowed examination of the female urethra in planes that could not be visualized by conventional sonography. The rhabdosphincter had a smaller volume in women with genuine stress incontinence than in continent women.

Hormone replacement therapy in postmenopausal women: carotid intima-media thickness and 3-D volumetric plaque quantification

Objective:The relationship between postmenopausal hormone replacement therapy (HRT) and the risk of stroke has been investigated in a number of epidemiological studies. However, data concerning the quantitative effects of HRT on carotid atherosclerosis, as measured by noninvasive ultrasound methods, are sparse. Methods: In the present case, we examined 55 postmenopausal women (mean age 57.6±4.2 years) who were treated for 4.7 years with estrogens, either alone ( n=11) or in combination with progestins ( n=44). They were compared to 46 control subjects without HRT who were matched for age, hypertension, and various other vascular risk factors. At the study onset and 1.5 years later, all participants were examined by Doppler ultrasound and B-mode sonography, and plaque visualization, intima-media-thickness (IMT) and volumetric quantification of carotid plaques was performed. Results: The HRT group had a significantly lower incidence of carotid plaques (18%) than the control group (61%). The mean IMT for the HRT subjects was 0.52 mm in the common carotid artery and 0.46 mm in the internal carotid artery, as compared to 0.68 and 0.62 mm, respectively, for the control subjects. No significant changes in IMT were found in either group. 3-D evaluation of carotid plaques showed increased plaque volume in women without HRT compared to women with HRT. Conclusion: We have obtained quantitative data using different noninvasive ultrasound techniques which demonstrate that women receiving HRT develop less severe carotid atherosclerosis, an effect which may be mediated by direct hormonal effects on the carotid wall and, in part, by the indirect influence of hormones on lipoproteins. HRT may, indeed, be more effective on existing atherosclerotic plaques.

Ovarian stromal echogenicity in women with clomiphene citrate–sensitive and clomiphene citrate–resistant polycystic ovary syndrome

Objective: To compare stromal echogenicity in women with clomiphene citrate (CC)–sensitive and CC-resistant polycystic ovary syndrome (PCOS), and to compare stromal echogenicity before and after laparoscopic ovarian drilling in women with CC-resistant PCOS. Design: Prospective study. Setting: University teaching hospital. Patient(s): Twenty-two infertile women. Intervention(s): Transvaginal ultrasound examination and laparoscopic ovarian drilling. Main Outcome Measure(s): Ovarian stromal index (ratio of mean ovarian stromal echogenicity to mean echogenicity of the entire ovary). Result(s): The mean (±SD) ovarian stromal index was 1.26 ± 0.27 in the women with CC-sensitive PCOS and 1.22 ± 0.11 in the women with CC-resistant PCOS. The ovarian stromal index and ovarian volume of the women with CC-resistant PCOS before and after ovarian drilling were not significantly different. Conclusion(s): There was no difference in the stromal index and ovarian volume between women with CC-sensitive PCOS and women with CC-resistant PCOS. There was no overall difference in the stromal index and ovarian volume in women with CC-resistant PCOS before and after ovarian drilling.

Urinary Free Cortisol Is Not Affected by Short-term Water Diuresis

Urinary free cortisol (UFC) has been shown to be a reliable measure of adrenocortical secretion, and it is generally accepted as being an index of the free fraction in the plasma. However, the interpretation of UFC results reportedly can be compromised when the urine volume in patients is considerably increased because a high fluid intake (5 L/day) increases UFC in healthy subjects (1) and UFC was reported to be closely related with the changes in urine volume in women (2). The aim of this work was to determine whether short-term changes in urine volume influence UFC. I studied 15 volunteers (6 women and 9 men) with normal body mass indexes (23.9 ± 1.9 kg/m …

A cross-sectional study of platelet volume in healthy normotensive women with bilateral uterine artery notches.

High uterine artery resistance characterized by bilateral notches seen on Doppler ultrasound in the second half of pregnancy is associated with an increased risk of adverse outcome related to pre-eclampsia and intrauterine growth retardation. We sought to establish whether there was a difference in platelet volume in healthy, normotensive women with high-resistance uterine artery Doppler findings compared to those with normal uterine artery Doppler findings. Forty-seven women were allocated prospectively into 'bilateral notch' and 'no notch' groups at color Doppler imaging of the uterine arteries carried out at a mean of 26 weeks' gestation. The difference in platelet volume between the two groups and the relationship of adverse outcome with raised platelet volume and high-resistance uterine artery Doppler findings was investigated. Twenty-three women had no evidence of uterine artery notches and 24 had bilateral uterine artery notches. Platelet volume in the women with bilateral notches was greater than in those with no notches (8.28 fl vs. 7.46 fl; p = 0.01). However, unlike high-resistance uterine artery Doppler findings, increased platelet volume was not associated with adverse outcome. Uterine artery Doppler flow abnormalities have not previously been studied in combination with hematological or biochemical markers. Our findings show, for the first time, that women with bilateral uterine artery notches have an increased platelet volume compared to those with normal uterine artery Doppler findings many weeks before clinical signs of pre-eclampsia or fetal growth retardation are evident. Women with abnormal uterine artery flow at this gestation may have other cardiovascular and hematological differences compared to those with normal flow.

Hippocampal volume in women victimized by childhood sexual abuse.

Several prior studies have found reduced hippocampal volume in victims of psychological trauma with post-traumatic stress disorder (PTSD). We were interested to determine if this finding was evident in women who were victimized by severe sexual abuse in childhood. In this study, hippocampal volume was measured using quantitative magnetic resonance imaging (MRI) in 21 women who reported being severely sexually abused in childhood and 21 socio-demographically similar women without abuse histories. Women who reported sexual victimization in childhood had significantly reduced (5% smaller) left-sided hippocampal volume compared to the non-victimized women. Hippocampal volume was also smaller on the right side, but this failed to reach statistical significance. Left-sided hippocampal volume correlated highly (rs = -0.73) with dissociative symptom severity, but not with indices of explicit memory functioning. These findings, which are generally consistent with prior reports of reduced hippocampal volume in combat veterans with PTSD, suggest that diminished hippocampal size may be either a consequence of trauma exposure or a risk factor for the development of psychiatric complications following trauma exposure. The observed relationship between symptom severity and hippocampal volume suggests that mesial temporal lobe dysfunction may directly mediate certain aspects of PTSD and dissociative disorder symptomatology.

Urethral sphincter volumes in women with obstructed voiding and abnormal sphincter electromyographic activity.

To investigate the role of transrectal ultrasonography (TRUS) of the female urethral sphincter and to compare sphincter volumes in controls and women with obstructed voiding associated with abnormal myotonic-like electromyographic (EMG) activity in the urethral sphincter. Fourteen women patients (mean age 29 +/- 3.2 years) with symptoms of urinary outlet obstruction underwent videocystometrography (VCMG), urethral sphincter EMG and TRUS. Their sphincter volumes were compared with those obtained from 20 age-matched control patients with other urodynamic diagnoses or normal urodynamics. In every patient the urethral sphincter was identified as an ovoid, hypoechoic structure distal to the bladder outlet. The mean volume of the sphincter in those patients with abnormal EMG activity (3.05 +/- 0.23 cm3) was significantly greater than that in the control group (1.30 +/- 0.09 cm3; P < 0.001). TRUS provided a useful method of imaging the urethral sphincter in women. The results suggest that there was an increase in the volume of the urethral sphincter in females with obstructed voiding, providing collateral evidence that the abnormal EMG activity is a significant factor in the pathophysiology of the disorder.

Acute maternal hydration in third-trimester oligohydramnios: Effects on amniotic fluid volume, uteroplacental perfusion, and fetal blood flow and urine output

OBJECTIVE: Our purpose was to determine whether acute maternal hydration in pregnancies with third-trimester oligohydramnios (1) increases amniotic fluid index and hourly fetal urine production rate and (2) alters uteroplacental perfusion and fetal blood flow. STUDY DESIGN: Ten women with third-trimester oligohydramnios (amniotic fluid index ≤5 cm) and 10 controls with normal amniotic fluid volume (amniotic fluid index >7 cm) were prospectively recruited for this study. Maternal plasma and urine osmolality, amniotic fluid index, hourly fetal urine production rate, and Doppler flow velocimetry of maternal uterine artery and fetal umbilical, descending aorta, middle cerebral, and renal arteries were determined before and after oral hydration by having the patient drink 2 L of water over 2 hours. RESULTS: There was a significant reduction in maternal plasma ( p < 0.05) and urine osmolality ( p < 0.0001) in both groups after short-term oral hydration. Hydration increased amniotic fluid volume in women with oligohydramnios (mean change in amniotic fluid index 3.2 cm, 95% confidence intervals 1.1 to 5.3; p < 0.02) but not in those with normal amniotic fluid volume (mean change in amniotic fluid index −2.0, 95% confidence intervals −4.1 to +0.2). The hourly fetal urine production rate, however, did not increase in either group (mean change in hourly fetal urine production rate 3.5 ml/hr, 95% confidence intervals −11.7 to +18.7 and −6.8 ml/hr, 95% confidence intervals −2.9 to −10.7, respectively). Hydration was associated with an increased in uterine artery mean velocity in the oligohydramnios group (mean change in mean velocity 16.7 cm/sec, 95% confidence intervals 8.0 to 25.3; p < 0.006) but not in controls (mean change in mean velocity 1.2 cm/sec, 95% confidence intervals −19.7 to +22.1). There was no change in pulsatility index or in velocity in any of the fetal vessels studied in either group. CONCLUSIONS: Short-term maternal oral hydration increases the amniotic fluid index in women with third-trimester oligohydramnios. Although the mechanism for this effect remains unclear, it could not be accounted for by fetal urination in this study but instead was associated with improved uteroplacental perfusion.

Employment of Urban Chinese Women

Employment of Urban Chinese Women Volume Lll, Number 1 of theReview of Social Economy includes an article by Gale Summerfield enrided “Effects of the Changing Employment Situation on Urban Chinese Women”.

Measurement of residual urine volumes in women: Urethral catheterization or transvaginal ultrasound?

The most practical and accurate method to measure residual urine volumes in women is yet to be determined. The practicality of transvaginal ultrasound in measuring the range of residuals typically encountered in a group of 100 symptomatic women attending for urodynamic investigations was tested and compared with urethral catheterization. Transvaginal ultrasound was found to be more comfortable, less invasive and quicker. In ideal circumstances for both techniques, mean time from voiding until residual assessment was 47 seconds for transvaginal ultrasound and 270 seconds for urethral catheterization. Transvaginal ultrasound was applicable to 99% of women, with accurate assessment of residuals possible in 96% (100% for urethral catheterization). Eighty-five percent of women were found to have a residual under the level of likely clinical significance (30 ml). Transvaginal ultrasound permits the avoidance of catheterization in these women. Transvaginal ultrasound allows for immediate retesting of the residual, a feature not possible if there is bladder drainage by urethral catheterization. Of the 22 women with residuals initially over 30 ml, 11 (50%) were able to lower this by an average of 69%, 7 (32%) of these to under 30 ml, with an immediate further attempt at voiding. In terms of practicality, transvaginal ultrasound is the method of choice for residual determination in the vast majority of women attending for urodynamic investigations. While it is not possible to directly compare the accuracy of the two techniques, a theoretical comparison is possible by summation of their respective sources of error. This comparison showed that the two techniques, in ideal circumstances, have similar accuracies over the range 0–175 ml. In non-ideal circumstances, urethral catheterization has more potential sources of error.