Such cases require close medical attention since it may be necessary to introduce early drug therapy or surgical intervention to improve the bladder emptying. Large post-void residual urine volume (greater than 150 ml) after onabotulinumtoxinA injection was significantly higher in the frail elderly group than in the other groups (60.7 vs 39.7 and 35.7, respectively, p 0.018). The positive predictive value for bacterial growth at a post-void residual volume of 180 ml or greater was 87.0% and the negative predictive value was 94.7%.Ĭlinically asymptomatic adult men with a post-void residual volume of 180 ml are at a high risk for bacteriuria. We evaluated 61 frail elderly patients, 63 who were elderly without frailty and 42 younger than 65 years. The post-void residual volume value of 180 ml was determined to have the best specificity and sensitivity. The mean post-void residual volume in this group was 257 ml (range 150 to 560) compared to 133 ml (range 10 to 340) for the group with negative culture (p <0.001). Overall 27% of the patients presented with a positive urine culture. A post-void residual of > 100 should raise suspicion about a mechanical, pharmaceutical, or neurogenic cause of retention. Urine samples were collected for culture from each patient and the results were compared to the various post-void residual volume. Patients at risk for retention who are discharged with a residual volume already approaching full bladder capacity would be predicted to be at considerable risk of overdistention after discharge. Right after spontaneous voiding, bladder catheterization was performed under normal aseptic conditions, and the post-void residual volume measured. Our study also demonstrates that some patients who are able to void spontaneously still have a large post-void residual volume (> 600 ml). In this prospective study we determined the cutoff value for post-void residual volume that places adult men at risk for bacteriuria.ĭata were obtained from 196 consecutive healthy adult men (median age 62 years) who came for prostate evaluation without symptoms of acute urinary tract infection. However, the maximum post-void residual volume that predisposes patients to a higher risk of urinary tract infection is not known. Large post-void residual urinary volume may be related to the development of urinary tract infection.
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