Duke University Medical Center, Durham, NC.
Arbor Research Collaborative for Health, Ann Arbor, MI.
Urology. 2019 Aug;130:22-28. doi: 10.1016/j.urology.2019.01.069. Epub 2019 Apr 21.
To describe the distribution of post-void residual (PVR) volumes across patients with and without lower urinary tract symptoms (LUTS) and examine relationships between self-reported voiding symptoms, storage symptoms, and PVR.
PVR and demographic data were obtained from the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN) observational cohort study. Self-reported symptoms were collected using the American Urological Association Symptom Index and the LUTS Tool. PVR values were obtained from 2 other cohorts: living kidney donors with unknown LUTS from the Renal and Lung Living Donors Evaluation Study (RELIVE), and continent women in the Establishing the Prevalence of Incontinence (EPI) study, a population-based study of racial differences in urinary incontinence prevalence.
Across the 3 studies, median PVRs were similar: 26 mL in LURN (n = 880, range 0-932 mL), 20 mL in EPI (n = 166, range 0-400 mL), and 14 mL in RELIVE (n = 191, range 0-352 mL). In LURN, males had 3.6 times higher odds of having PVR > 200 mL (95% CI = 1.72-7.48). In RELIVE, median PVR was significantly higher for males (20 mL vs 0 mL, P= .004). Among women, only the intermittency severity rating was associated with a probability of an elevated PVR. Among men, incomplete emptying and burning severity rating were associated with a higher odds of elevated PVR, but urgency severity ratings were associated with lower odds of elevated PVR.
Care-seeking patients have PVRs similar to those in people with unknown history of LUTS (RELIVE) and without self-reported LUTS (EPI). Although PVR was correlated with voiding symptoms, the mean differences only explain ∼2% of the variance.
描述下尿路症状(LUTS)患者和无 LUTS 患者的剩余尿量(PVR)分布情况,并探讨自报排尿症状、储尿症状与 PVR 之间的关系。
PVR 和人口统计学数据来自下尿路功能障碍症状研究网络(LURN)的观察性队列研究。使用美国泌尿协会症状指数和 LUTS 工具收集自报症状。PVR 值来自另外两个队列:来自肾脏和肺活体供者评估研究(RELIVE)的未知 LUTS 的活体供者,以及基于人群的尿失禁流行率种族差异研究(EPI)中的有控尿女性。
在这 3 项研究中,中位数 PVR 相似:LURN 为 26 mL(n=880,范围 0-932 mL),EPI 为 20 mL(n=166,范围 0-400 mL),RELIVE 为 14 mL(n=191,范围 0-352 mL)。在 LURN 中,男性 PVR>200 mL 的几率是女性的 3.6 倍(95%CI=1.72-7.48)。在 RELIVE 中,男性的中位数 PVR 明显高于女性(20 mL 比 0 mL,P=0.004)。在女性中,只有间歇性严重程度评分与发生高 PVR 的概率相关。在男性中,不完全排空和烧灼感严重程度评分与发生高 PVR 的几率较高相关,而急迫感严重程度评分与发生高 PVR 的几率较低相关。
就诊患者的 PVR 与未知 LUTS 病史(RELIVE)和无自报 LUTS(EPI)患者的 PVR 相似。尽管 PVR 与排尿症状相关,但平均差异仅能解释约 2%的方差。