Correlation of Post-Void Residual Volume to Urologic Symptoms in Multiple Sclerosis

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Post-void residual urine was measured by ultrasound or catheterization.
Post-void residual urine was measured by ultrasound or catheterization.

A recent study published in The Journal of Urology found that post-void residual volume (PVR) is not associated with an elevated risk for recurrent urinary tract infections (UTIs), worsening incontinence, or worsening obstructive lower urinary tract symptoms in individuals with multiple sclerosis and lower urinary tract symptoms.

The study analyzed post-void residual volume in a cohort of 110 patients with multiple sclerosis and lower urinary tract symptoms to determine whether there was an association between post-void residual volume, UTIs, and self-reported urinary symptoms. Participants were included in the study if they had at least 1 post-void residual volume measure obtained by catheterization or ultrasound and a diagnosis of multiple sclerosis. Incontinence was assessed using the Michigan Incontinence Symptom Index (M-ISI), and the American Urological Association Symptom Index (AUA SI) was used for lower urinary tract symptom screening.

The average post-void residual volume for participants was 123.4 mL (range 0-650cc) and the AUA mean symptom score for participants was 19.1, with a 4.1 average bother score. Data analyses did not indicate an association between higher post-void residual volume and increased AUA symptom or bother score (=.53 and P=.44, respectively), nor any correlation between higher post-void residual volume  and history of recent recurrent UTIs (=.27). No relationship between PVR group and AUA SI or M-ISI was indicated (=.54 and P=.57, respectively).

Study investigators conclude, “Elevated [post-void residual volume] was common among [multiple sclerosis] patients with [lower urinary tract symptoms] presenting to our clinic: almost half of patients met the UK guidelines for [multiple sclerosis] related urinary retention, and 10% of patients would qualify under the French consensus. However, within our sample, elevated [post-void residual volume] was not associated with worsening [lower urinary tract symptoms] as assessed by AUA [symptom score], worsening incontinence as measured by M-ISI score or increased risk of recurrent UTI.”

Reference

Dray E, Cameron AP, Clemens JQ, Qin Y, Covalschi D, Stoffel J. Does post-void residual volume predict worsening urologic symptoms in patients with multiple sclerosis? [published online April 24, 2018]. J Urol. doi: 10.1016/j.juro.2018.04.068

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