Abstract
Background
It is commonly recommended to catheterize or closely follow up patients with post-void
residual volumes of 150 mL or more, but the frequency of such findings in geriatric
hospitalized patients and the need for intervention are unclear.
Methods
Post-void residual volumes were measured by ultrasound examination within 14 hours
of admission in 464 patients aged 70 years or more who were hospitalized in a regional
hospital general internal medicine department. Outcome variables included the need
for an indwelling catheter and complications of urinary retention during the hospitalization.
Results
Post-void residual volumes of ≥150 mL were common (23.9%; 111/464) and had the following
distribution: 150 to 299 mL, 13.1% (61/464); 300 to 499 mL, 6.4% (30/464); and 500
mL or more, 6% (28/464). The rate of indwelling catheters was 3.2% (15/464). Results
of post-void residual volumes did not predict the need for indwelling catheters in
those without other criteria, although those with indications for indwelling catheters
had a significantly higher frequency of post-void residual volumes ≥500 mL (P < .001) compared with those without such indications.
Conclusions
We conclude that urinary retention in hospitalized geriatric patients is common, but
measurements of post-void residual volumes did not have definite clinical utility.
However, the study had limited power to determine the benefits or potential harms
of urinary catheterization for elevated post-void residual volumes.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The American Journal of MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Secular trends in rates and etiology of nosocomial urinary tract infections at a university hospital.J Urol. 1993; 150: 414-416
- Nosocomial infections in combined medical-surgical intensive care units in the United States.Infect Control Hosp Epidemiol. 2000; 21: 510-515
- Nosocomial infections in U.S. hospitals, 1975–1976: estimated frequency by selected characteristics of patients.Am J Med. 1981; 70: 947-959
- The nationwide nosocomial infection rate. A new need for vital statistics.Am J Epidemiol. 1985; 121: 159-167
- Urinary retention in a general rehabilitation unit: prevalence, clinical outcome, and the role of screening.Arch Phys Med Rehabil. 2005; 86: 1772-1777
- Urinary retention and post-void residual urine in men: separating truth from tradition.J Urol. 2008; 180: 47-54
- Will more restrictive indications decrease rates of urinary catheterisation? An historical comparative study.BMJ Open. 2012; 2: e000473
- A quantitative comparison of four current portable ultrasound bladder scanners.Br J Med Surg Urol. 2008; 1: 35-40
- Utility of bedside bladder ultrasound before urethral catheterization in young children.Pediatrics. 2005; 115: 108-111
- Urodynamic findings in chronic retention of urine and their relevance to results of surgery.Br Med J. 1978; 2: 1258-1260
- Relationship between detrusor function and residual urine in men undergoing prostatectomy.Br J Urol. 1987; 60: 560-566
- Evaluation of voiding dysfunction and measurement of bladder volume.Rev Urol. 2004; 6: S32-S37
- A prospective randomized trial comparing transurethral prostatic resection and clean intermittent self-catheterization in men with chronic urinary retention.BJU Int. 2005; 96: 93-97
- Urinary retention in hospitalized elderly women.J Gerontol Nurs. 1993; 19: 7-14
- The effectiveness of implementing a bladder ultrasound programme in neurosurgical units.J Adv Nurs. 2007; 57: 192-200
- Micturitional disturbance in acute disseminated encephalomyelitis (ADEM).J Auton Nerv Syst. 1996; 60: 200-205
- Placebo controlled, randomized, double blind study of the effects of botulinum A toxin on detrusor sphincter dyssynergia in multiple sclerosis patients.J Neurol Neurosurg Psychiatry. 2005; 76: 1670-1676
- Incidence and outcome of post stroke urinary retention: a prospective study.Arch Phys Med Rehabil. 2000; 81: 1464-1467
- Geriatric rehabilitation: nursing interventions and outcomes focusing on urinary function and knowledge of medications.Rehabil Nurs. 1996; 21: 142-147
- Estimating equations for glomerular filtration rate in the era of creatinine standardization. A systematic review.Ann Intern Med. 2012; 156: 785-795
- Prevalence of incomplete bladder emptying among elderly in convalescent wards: a pilot study.Asian J Gerontol Geriatr. 2006; 1: 66-67
- Is conservative management of chronic retention in men ever justified?.BJU Int. 2003; 92: 581-583
- Variability of post-void residual urine volume in the elderly.Urol Res. 1996; 24: 23-26
- Urinary retention in patients in a geriatric rehabilitation unit: prevalence, risk factors, and validity of bladder scan evaluation.Rehabil Nurs. 2001; 26: 187-191
- Unnoticed post-void residual urine volume in people with moderate to severe intellectual disabilities: prevalence and risk factors.J Intellect Disabil Res. 2009; 53: 772-779
- Post void residual volume in patients at geriatric ward.Ugeskr Laeger. 2010; 172: 1512-1516
Article Info
Publication History
Published online: September 02, 2014
Footnotes
Funding: None.
Conflict of Interest: None.
Authorship: All authors had access to the data and played a role in writing this manuscript.
Identification
Copyright
© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.