Elevated Postvoid Residual Urine Volume: Identifying Risk Factors and Predicting Resolution in Women With Pelvic Organ Prolapse

Abstract

Objectives: This study aims to identify risk factors for elevated preoperative postvoid residual (PVR) and persistently elevated postoperative PVR and to evaluate the resolution rate of elevated PVR urine volume in patients undergoing reconstructive surgery for pelvic organ prolapse (POP).

Methods: This was a retrospective cohort study comparing 50 women with elevated preoperative PVR (≥100 mL) and 50 women with normal PVR (<100 mL). Preoperative demographic, physical examination, urodynamic data, type of surgery performed, and postoperative trial of void data were collected. Variables were evaluated for association with elevated PVR using Student t test or Mann-Whitney U test, and χ or Fisher exact test.

Results: The elevated PVR cohort was older (65.5 ± 13.3 vs 60.6 ± 10.1 years, P = 0.04). The cohorts did not differ by body mass index, parity, number of cesarean deliveries, prior hysterectomy, incontinence, prolapse surgery, menopausal status, hormone replacement therapy, history of recurrent urinary tract infections, diabetes mellitus, or maximum bladder capacity. Most patients had preoperative anterior prolapse stage 2 or 3. Complaints of incontinence, incomplete bladder emptying, and overactive bladder did not differ between groups. Performed Surgical procedures, cystoscopy findings, and rate of postoperative trial of void failures did not differ between groups. One patient per cohort learned clean intermittent self-catheterization for persistently elevated PVR.

Conclusions: All women undergoing surgery for POP had postoperative resolution of elevated PVR. Patients with nonneurogenic-elevated PVR can be reassured that bladder emptying will improve after surgical repair of POP.