NON-INVASIVE METHOD TO DIAGNOSE, WITHOUT MATERIAL RESOURCES, HIGH POST VOID RESIDUAL URINE VOLUME AFTER PROLAPSE OR INCONTINENCE SURGERY
E. ALCOBA, A. E. SAMPIETRO, S. ALTUNA;
Hosp. Univ.rio Austral, Buenos Aires, Argentina.
Introduction: Voiding dysfunction is a common complication following surgical correction of stress urinary incontinence or prolapse surgery. It is characterized by urinary retention, obstructive voiding symptoms, and overactive bladder symptoms. (1)
The incidence is about 5%. Post-void residual urine is considered pathologic when the value is above 100 ml or 30% of the total voided volume. (2)
The gold standard to measure post-void residual volume is transurethral catheter. Also ultrasound is effective. (3)
In case access to ultrasound is restricted or professionals don't want to use an invasive method, it would be necessary to have a tool that can replace both.
Objective: The aim of this study is to determine if with a simple questionnaire we can predict high post-void residual urine volume or not
Methods: Cross sectional study.
209 Post prolapse and/or midurethral sling surgery patients were selected. 115 were excluded for missing data, 2 were excluded for bladder injury leaving a total of 92 patients to analyze.
A 3 yes or no simple questionnaire was made after the first time the patient voided after surgery
1- Did you empty your bladder the same way you did before the surgery?
2- Is the stream lower?
3- Do you feel your bladder completely empty?
After the questionnaire, post-void residual urine volume was measured with transurethral catheter.
Results: From the 92 cases, 15 had high post-void residual volume by catheterism, a prevalence of 16,3% (IC 95% 9.71-25.99). All the 15 patients had at least 1 altered answer that leads us to the diagnose of the pathology, 11 had 2, and 5 patients had the 3 of them.As a diagnostic test, results gives us a 100% sensibility, 90,91% specificity, positive predictive value 68,18% and a negative predictive value of 100% (figure 1) None of the questions analyzed individually had the same results as if they are analyzed all together (sensibility of 66,67% for the first and the second question, 80% for the third one)
Conclusions: It is possible to approach to diagnose high post-void residual urine volume with 3 simple questions, without using invasive methods
References: 1. Post-void residual urine under 150 ml does not exclude voiding dysfunction in women 2. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. 3. Accuracy and precision of a new portable ultrasound scanner, the BME-150A, in residual urine volume measurement: a comparison with the BladderScan BVI 3000