title: Clinical significance of postvoid residual volume in older ambulatory women.
abstract: OBJECTIVE
  To examine the prevalence, natural history, and clinical significance of high postvoid residual (PVR) volume in ambulatory older women.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Group health plan in Washington state.
  
  
  METHODS
  Nine hundred eighty-seven ambulatory women aged 55 to 75.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Medicine, University of California at San Francisco, San Francisco, California, USA. ahuang@ucsfmed.org
authors.forename: Alison J
authors.initials: AJ
authors.lastname: Huang
authors.forename: Jeanette S
authors.initials: JS
authors.lastname: Brown
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Boyko
authors.forename: Elya E
authors.initials: EE
authors.lastname: Moore
authors.forename: Delia
authors.initials: D
authors.lastname: Scholes
authors.forename: Louise C
authors.initials: LC
authors.lastname: Walter
authors.forename: Feng
authors.initials: F
authors.lastname: Lin
authors.forename: Eric
authors.initials: E
authors.lastname: Vittinghoff
authors.forename: Stephan D
authors.initials: SD
authors.lastname: Fihn
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D053158:Nocturia / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology; D011446:Prospective Studies; D012016:Reference Values; D012307:Risk Factors; D014463:Ultrasonography; D014550:Urinary Incontinence, Stress / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology; D053202:Urinary Incontinence, Urge / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology; D014552:Urinary Tract Infections / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology; D014555:Urination Disorders / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology*; D014563:Urodynamics / Q000502:physiology*