May Matthias, Brookman-Amissah Sabine, Hoschke Bernd, Gilfrich Christian, Braun Kay-Patrick, Kendel Friederike
Department of Urology, Carl-Thiem-Klinikum Cottbus, Cottbus, Germany.
J Urol. 2009 Jun;181(6):2540-4. doi: 10.1016/j.juro.2009.01.103. Epub 2009 Apr 16.
Post-void residual urine can lead to various complications, including urinary tract infection. Recently investigators calculated that a cutoff value of 180 ml has considerably high sensitivity and specificity for significant bacteriuria in asymptomatic men. We determined the association between post-void residual urine volume and urinary tract infection, and validated the suggested 180 ml cutoff in asymptomatic men.
In a prospective study we analyzed certain criteria in 225 asymptomatic male patients, including prostate specific antigen, prostate volume, International Prostate Symptom Score, peak urine flow rate, urine culture results and post-void residual urine volume using transabdominal ultrasound. Using ROC analysis a cutoff predicting bacteriuria was calculated. Different cutoff values were validated.
Of the study group 60% were able to completely empty the bladder and had a post-void residual urine volume of 10 ml or less. However, in 31% of the study group urine culture was positive. Patients presenting with urinary tract infection had significantly higher mean post-void residual urine volume than patients without urinary tract infection (113 vs 41 ml, p <0.001). In 29 men (13%) post-void residual volume was 180 ml or greater. Confirming urinary tract infection, this cutoff showed only 28% sensitivity and 94% specificity (AUC 0.606, p = 0.01).
No cutoff value could be determined to predict positive urine culture with sufficient sensitivity and specificity. Based on the results of the current study it seems premature to recommend a cutoff value leading to therapeutic consequences.
排尿后残余尿量可导致多种并发症，包括尿路感染。最近，研究人员计算出，180ml的临界值对无症状男性显著菌尿具有相当高的敏感性和特异性。我们确定了排尿后残余尿量与尿路感染之间的关联，并验证了对无症状男性建议的180ml临界值。
在一项前瞻性研究中，我们分析了225例无症状男性患者的某些标准，包括前列腺特异性抗原、前列腺体积、国际前列腺症状评分、最大尿流率、尿培养结果以及经腹部超声测量的排尿后残余尿量。使用ROC分析计算预测菌尿的临界值。对不同的临界值进行了验证。
研究组中60%的患者能够完全排空膀胱，排尿后残余尿量为10ml或更少。然而，研究组中有31%的患者尿培养呈阳性。患有尿路感染的患者的平均排尿后残余尿量显著高于无尿路感染的患者（113ml对41ml，p<0.001）。29名男性（13%）的排尿后残余尿量为180ml或更多。在确诊尿路感染方面，这个临界值的敏感性仅为28%，特异性为94%（AUC 0.606，p=0.01）。
无法确定一个具有足够敏感性和特异性来预测尿培养阳性的临界值。基于当前研究结果，推荐一个会导致治疗后果的临界值似乎为时过早。
