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KMID : 1011820210620040470
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Investigative and Clinical Urology
2021 Volume.62 No. 4 p.470 ~ p.476
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Post-void residual urine ratio: A novel clinical approach to the post-void residual urine in the assessment of males with lower urinary tract symptoms
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Rubilotta Emanuele
Balzarro Matteo
Trabacchin Nicolo
Righetti Rita
D’Amico Antonio
Blaivas Jerry G.
Antonelli Alessandro
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Abstract
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Purpose: To assess the correlation between post-void residual urine ratio (PVR-R) and pathological bladder emptying diagnosed by pressure-flow studies (PFS) in males with lower urinary tract symptoms (LUTS).
Materials and Methods: PVR-R and PVR urine were evaluated in 410 males underwent PFS for LUTS. PVR-R was the percentage of PVR to bladder volume (voided volume+PVR). Schafer and International Continence Society (ICS) nomograms, Bladder Contractility Index (BCI) were used to diagnose bladder outlet obstruction (BOO) and detrusor underactivity (DUA). We subdivided the cohort in 4 groups: Group I, BOO+/DUA+; Group II, BOO-/DUA+; Group III, BOO+/DUA?; Group IV, BOO?/DUA? (control group). We subdivided the 4 groups according to PVR-R strata: (1) 0%?20%; (2) 21%?40%; (3) 41%?60%; (4) 61%?80%; (5) 81%?100%.
Results: Group I had a greater median PVR-R (50%) with a >40% in 61.4% of the cohort. Median PVR-R was 16.6% in Group II, 24% in Group III, and 0% in the control Group. According to ICS nomograms and BCI, median PVR-R and PVR were significantly higher (p<0.001) in obstructed and underactive males. PVR-R threshold of 20% allowed to recognize males with voiding disorders with high sensibility, specificity, PPV, and NPV. A PVR-R cut-off of 40% identified males with associated BOO and DUA and more severe voiding dysfunction.
Conclusions: A higher PVR-R is related to a more severe pathological bladder emptying, and to the association of BOO and DUA. PVR-R may have a clinical role in first assessment of males with LUTS and severe voiding dysfunction.
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KEYWORD
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Bladder outlet obstruction, Detrusor underactivity, Lower urinary tract symptoms, Males, Urodynamics
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