Postvoid Residual Urine Measurement in Parous Women with Lower Urinary Tract Symptoms: A Prospective Analytic Study.

Document Type : Original Article

Authors

1 Resident of Obstetrics and Gynecology, Mansoura University, Egypt

2 Professor of Obstetrics & Gynecology, Faculty of Medicine, Mansoura University, Egypt

3 Associate Professor of Obstetrics&Gynecology, Faculty of Medicine, Mansoura University, Egypt

Abstract

Abstract
Background: There are many different bladder complaints that are classified as lower urinary tract symptoms (LUTS). These could be divided into three classes; frequency and nocturia, and storage manifestations of urgency either in presence or absence of urgency urinary incontinence (UUI). Other LUTS include voiding problems like straining, hesitancy, a sense of incomplete emptying, and slow stream. Most of these symptoms are related to vaginal delivery (VD), however bladder dissection during cesarean delivery (CD) may associated with such symptoms.   
Objective: To assess the post voiding residual urine and LUT symptoms in parous women with different routes of delivery.  
Patients and Methods: We recruited 80 females who were distributed into two groups according to the mode of previous deliveries; group A that included females with previous VD (40 patients) and group B that included females with previous cesarean delivery (40 patients), they were subjected to full history taking (to analyze the presence of different symptoms and other risk factors) and clinical examination (including local examination to assess the state of the pelvic organs). Trans-abdominal ultrasound examination was done to evaluate post-Void Residual (PVR) urine volume was measured in all the cases and correlated with the other symptoms and signs.
Results: There was statistically significantly higher prevalence of positive stress test in the VD group. The mean PVR was statistically significantly elevated in the VD group In comparison with cesarean delivery. There was no statistically significant difference between the two groups in terms of LUTS such as frequency, nocturia, urgency, slow stream, splitting, intermittent stream, hesitancy, straining, and terminal dribbling. The prevalence of incomplete emptying and post-micturition dribbling was statistically significantly elevated in the VD group. Degree of prolapse was statistically significantly elevated in the vaginal delivery group.  
Conclusion: The current study revealed that; PVR urine volume was found to be higher in parous women after VD and complaining of pelvic organ prolapse (POP). We recommend using PVR evaluation as a screening approach for all women complaining of LUT symptoms and with history previous vaginal delivery. 

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