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Vol. 40. Issue 5.
Pages 309-316 (June 2016)
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Vol. 40. Issue 5.
Pages 309-316 (June 2016)
Original article
The relationship between the sensation of incomplete voiding and a high postvoid residual volume
La relación entre la sensación de vaciado incompleto y un residuo posmiccional elevado
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A.A. Cayetano-Alcaraz
Corresponding author
, J.O. Herrera-Cáceres, A. García-Mora
Departamento de Urología, Instituto Nacional de Ciencias Médicas y Nutrición «Salvador Zubirán», Ciudad de México, Mexico
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Tables (5)
Table 1. Characteristics of the population.
Table 2. Characteristics of the sensation of incomplete emptying as a diagnostic test for a high post-void residue.
Table 3. Degree of concordance between a high postvoid residue and the presence of lower urinary tract symptoms evaluated in the IPSS questionnaire.
Table 4. Overall results and by gender of the IPSS questionnaire.
Table 5. Univariate and multivariate binary logistic regression model for prediction of a high post-void residue.
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Abstract
Background

Studies have shown that voiding symptoms do not correlate with a high postvoid residual volume. It is important to have clinical tools that help make early and effective decisions during the initial consultation.

Objective

To assess the validity and degree of concordance between the sensation of incomplete voiding and high postvoid residual volume.

Materials and methods

Cross-sectional study of patients who underwent uroflowmetry (UFM) and postvoid residual volume (PVR) measurement due to lower urinary tract symptoms, with simultaneous scoring of International Prostate Symptom Score (IPSS), the International Consultation on Incontinence Questionnaire – Female Lower Urinary Tract Symptoms (ICIQ-FLUTS) or Male Lower Urinary Tract Symptoms (ICIQ-MLUTS) during 2014–2015. We analyzed the relationship between these data and the postvoid residual volume.

Results

The study included 303 patients, 75 (24.8%) of whom were women and 228 (75.2%) of whom were men. The mean age was 60.9 years (SD, 15.8), and the mean Qmax was 14.47mL/s (SD, 9.6). Sixty (19.8%) patients had a high PVR. We detected 240 (79.2%) patients with sensations of incomplete voiding (SIV), but its presence was not associated with a high PVR in the population. For the SIV, the sensitivity, specificity, positive and negative predictive values and positive and negative likelihood ratios were 81.6%, 21.3%, 20.4%, 82.5%, 1.03 and 0.85, respectively. The area under the curve for the frequency of SIV was 0.52 (95% CI, 0.44–0.60, p=0.5). The degree of concordance between SIV and high PVR was 0.014 (p=0.6). In the ICIQ-MLUTS, PVR correlated with intermittence (Rho=0.132, p=0.043) but not with SIV (Rho=0.09, p=0.15). In the ICIQ-FLUTS, the frequency of urinary incontinence was positively correlated with PVR (Rho=0.216, p=0.026).

Conclusions

The sensation of incomplete voiding is not associated with a high postvoid residual volume. Other variables such as symptom severity, urinary effort and total score for voiding symptoms can be associated with a high residual urine volume.

Keywords:
Sensation of incomplete voiding
Postvoid residual urine
Uroflowmetry
Lower urinary tract symptoms
Resumen
Antecedentes

Algunos estudios han demostrado que los síntomas de vaciado no correlacionan con el residuo posmiccional elevado. Es importante contar con herramientas clínicas que permitan tomar decisiones prontas y efectivas en la primera consulta.

Objetivo

Evaluar la validez y el grado de concordancia entre la sensación de vaciado incompleto y el residuo posmiccional elevado.

Material y métodos

Estudio transversal de pacientes a los que se les realizó uroflujometría (UFM) y medición de residuo posmiccional (RP) por síntomas urinarios inferiores con determinación simultánea de IPSS, ICIQ-FLUTS o ICIQ-MLUTS durante los años 2014-2015. Analizamos la relación entre estos datos con el volumen del residuo posmiccional.

Resultados

Se incluyeron 303 pacientes: 75 (24,8%) mujeres y 228 (75,2%) hombres, con una edad media de 60,9años (DE15,8) y un Qmáx medio de 14,47ml/s (DE9,6); 60 (19,8%) presentaron RP elevado. Se detectaron 240 (79,2%) pacientes con sensación de vaciado incompleto (SVI) y su presencia no se asoció a RP elevado en la población. Para la SVI, la sensibilidad, la especificidad, el valor predictivo positivo y negativo, y los cocientes de probabilidad positivos y negativos fueron de 81,6%, 21,3%, 20,4%, 82,5%, 1,03 y 0,85, respectivamente. El área bajo la curva para la frecuencia de SVI fue de 0,52 (IC95%, 0,44-0,60, p=0,5). El grado de concordancia entre SVI y RP elevado fue de 0,014 (p=0,6). En el cuestionario ICIQ-MLUTS correlacionó RP con intermitencia (Rho=0,132, p=0,043) y no con SVI (Rho=0,09, p=0,15). En el ICIQ-FLUTS la frecuencia de incontinencia urinaria correlacionó positivamente con el RP (Rho=0,216, p=0,026).

Conclusiones

La sensación de vaciado incompleto no se asocia a un residuo posmiccional elevado. Otras variables, como severidad de los síntomas, esfuerzo miccional y puntuación total de síntomas de vaciado, pueden asociarse con una orina residual elevada.

Palabras clave:
Sensación de vaciamiento incompleto
Orina residual posmiccional
Uroflujometría
Síntomas de tracto urinario inferior

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