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Erschienen in:
09.09.2023
Management of Elevated Post-Void Residual Volume
Erschienen in: Current Bladder Dysfunction Reports | Ausgabe 3/2023
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Purpose of Review
Elevated post-void residual volume (ePVR) also known as chronic urinary retention (CUR) is a chronic condition of incomplete bladder emptying in the absence of pain or discomfort. ePVR may be secondary to several etiologies: obstructive, neurogenic, vascular, myogenic, or a combination of these. It can be further divided into symptomatic (e.g., accompanied with lower urinary tract symptoms), or asymptomatic. In this article, we sought to review the literature regarding definition of ePVR, etiology, clinical significance, initial assessment, treatment, and follow-up.
Recent Findings
We performed a systematic review of current literature and leading urology association guidelines regarding the management of CUR. We recommend using a cut off for of greater than 300mL, in two separate measurements at least 6 months apart for the definition of CUR. Patient with CUR should be divided to low- and high-risk patients, according to their risk of developing complication related to urinary stasis or high intravesical pressure. The management and follow-up recommendations are different in both group and should be aimed at reducing complications and improving quality of life. While low-risk asymptomatic patients may be followed conservatively, high-risk patients should be monitored closely for worsening renal function and interventions may be needed in the high-risk group.
Summary
CUR is a chronic condition whose pathogenesis and complications are not fully understood. Management and follow-up of patients with CUR should be tailored to patient risk. Further research is necessary to better understand the clinical course, pathophysiology, and optimal therapeutic and diagnostic approach.