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post-void residual (PVR) volume

The amount of fluid remaining in the bladder immediately following the completion of urination. Reference interval: - normal post-void residual (PVR) volume is < 50-100 mL * no clear definition of what constitutes significant increase in PVR [1] Clinical significance: - there is no clear definition of a significant PVR - an asymptomatic man with no radiologic evidence of obstruction (hydronephrosis or bladder stones) does not need intervention [1] - PVR > 200 mL is clearly abnormal [2] Increased PVR volume is associated with: 1) urinary obstruction a) overflow incontinence b) benign prostatic hypertrophy (BPH) 2) impaired bladder contractility (neurogenic bladder) Procedure: - estimation of PVR volume can be made by abdominal palpation & percussion or bimanual examination - specific measurement of PVR can be accomplished by - catheterization - pelvic ultrasound - radiography - radioisotope studies Management: - PVR <= 200 mL can be monitored without intermittent catheterization or an indwelling urinary catheter [1] - PVR > 200 mL requires catheterization & evaluation for underlying cause(s) - no clear definition of what constitutes significant in PVR [1] - an asymptomatic man with no radiologic findings of significant obstruction can be managed expectantly - urinalysis & urine culture not indicated in the absence of indicators of urinary tract infection

Related

benign prostatic hyperplasia (BPH) overflow incontinence

General

urology

References

  1. Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013 - Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022
  2. UCLA Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 12-15, 2001
  3. Kaplan SA, Wein AJ, Staskin DR et al Urinary retention and post-void residual urine in men: separating truth from tradition. J Urol. 2008 Jul;180(1):47-54. Review. PMID: 18485378
  4. Noguchi N, Chan L, Cumming RG. Natural History of Post-Void Residual Urine Volume Over 5 Years in Community-Dwelling Older Men: The Concord Health and Ageing in Men Project. Neurourol Urodyn. 2018;37(3):1068-1073 PMID: 28940729 https://onlinelibrary.wiley.com/doi/10.1002/nau.23415
  5. Uzun H, Kadioglu ME, Metin NO et al. The Association of Postvoiding Residual Volume, Uroflowmetry Paramters and Bladder Sensation. Urol J. 2019;16(4):403-406 PMID: 30882173 https://journals.sbmu.ac.ir/urolj/index.php/uj/article/view/4368