Clinical implications of a feeling of incomplete emptying with little post-void residue in men with lower urinary tract symptoms
Lee JY, Lee DH, Lee H, Bang WJ, Hah YS, Cho KS. Neurourol Urodyn. 2013 Aug 14. doi: 10.1002/nau.22473. [Epub ahead of print]

Source

Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.

Abstract

AIM:

It remains unclear why patients suffer from a feeling of incomplete emptying despite no or little post-void residual (PVR). Accordingly, we evaluated the clinical implications thereof in men with lower urinary tract symptoms (LUTS).

METHODS:

Records were obtained from a prospectively maintained database for 905 first-visit men with LUTS. Patients with comorbidities that may affect voiding function and with PVR > 20 ml were excluded. Finally, 421 patients were eligible for the study.

RESULTS:

By International Prostate Symptom Score (IPSS), a score for evaluating a feeling of incomplete emptying, 106 patients (25.2%) were characterized as experiencing no symptoms (score 0, 1), 201 (47.7%) as mild to moderate symptoms (score 2, 3), and 114 (27.1%) as severe symptoms (score 4, 5). The severity of a feeling of incomplete emptying was significantly associated with total IPSS and with subscores for both voiding and storage symptoms (P < 0.001). Comparing patients with severe symptoms (severe group, N = 114) with a propensity score-matched control group, adjusting for age, PVR, and maximum flow rate, total IPSS was significantly different between the two groups (23.04 ± 5.68 vs. 13.21 ± 5.48, respectively; P < 0.001). The subscores for both voiding and storage symptoms were also significantly worse in the severe group. The quality of life score was 4.51 ± 0.80 in the severe group and 3.53 ± 1.05 in control group (P < 0.001).

CONCLUSIONS:

A feeling of incomplete emptying despite little PVR was frequently observed and, notably, this was significantly associated with worsening of both voiding and storage symptoms, even after adjusting for relevant variables.