(Poster 99) Postvoid Residual Variation Among Urogynecologic Diagnoses

Objectives: This study was done to evaluate and better define the distribution of postvoid residual (PVR) in urogynecologic patients and within specific urogynecologic diagnoses.

Methods: This study reviewed 2500 new patients presenting to a urogynecology clinic at an academic medical center 2021-2024. The charts of patients who required a PVR by bladder scan or in-and-out straight catheterization as part of their routine medical care were abstracted for PVR and diagnosis. Distribution curves were determined for the overall PVR value as well as the following diagnoses: anterior prolapse, posterior prolapse, apical prolapse, procidentia, all prolapse diagnoses, mixed urinary incontinence (MUI), urge urinary incontinence (UUI), stress urinary incontinence (SUI), overactive bladder (OAB) and lower urinary tract symptoms (LUTS), pain syndromes, vulvovaginal atrophy, urinary tract infection (UTI), and urinary retention. For each diagnosis, the PVR was compared between affected and unaffected (all other patients in the study) patients using Mann-U Whitney test to determine difference. This study was deemed exempt by the local IRB.

Results: Of the 2500 charts abstracted, PVR was recorded for 1580 patients, and the median PVR for the population was 30 ml [interquartile range (IQR) 0-60ml]. The median PVR for each diagnosis is shown in Table 1. As expected, patients with SUI had a significantly lower PVR than those unaffected and patients with urinary retention had a significantly higher PVR than those unaffected. Patients with prolapse (anterior, posterior, apical, procidentia, and all prolapse) had a significantly higher PVR than unaffected patients. Patients with atrophy and UTI had a significantly higher PVR than the unaffected. Patients with MUI, UUI, OAB/LUTS, and pain syndromes did not demonstrate a significantly different PVR compared to unaffected patients.

Conclusions: This large sample of patients provides normal PVR values for urogynecology patients and PVRs for various urogynecologic diagnoses. This data also supports the commonly held belief that prolapse is associated with some degree of urinary retention. It also demonstrates a relationship between urinary retention and UTI as well as vulvovaginal atrophy, which suggests further research is needed to determine the nature of this relationship.