Does Post-Void Residual Volume Predict Worsening Urologic Symptoms in Patients with Multiple Sclerosis?

Our goal was to examine how post-void residual (PVR) volumes relate to urinary symptoms in multiple sclerosis (MS) patients.

We performed a retrospective review of MS patients with lower urinary tract symptoms (LUTS) presenting to a tertiary neurourology clinic. Patients who had a PVR recorded at their initial urologic assessment were included in our analysis. Results of the American Urological Association Symptom Index (AUA-SI) and the Michigan Incontinence Symptom Index (M-ISI) completed at this visit were analyzed to assess severity of LUTS and incontinence, and a chart review was performed for demographic information and documented urinary tract infections (UTIs).

Between 2014 and 2017, 110 patients with a diagnosis of MS underwent PVR measurement in our clinic. The average post-void residual was 123.4ml (range 0-650cc). Mean AUA symptom score was 19.1 with an average bother score of 4.1 Analysis of PVR as a continuous variable did not show an association between increasing PVR and increasing AUA SI or bother score (p=0.53 and 0.44 respectively). When evaluated by PVR tertile, no relationship between AUA SI or M-ISI and PVR group was demonstrated (p=0.54, 0.57). No correlation was found between increasing PVR and recent history of recurrent UTIs (p=0.27).

Post-void residual volume was not associated with worsening obstructive LUTS as assessed by AUA SI, worsening incontinence as measured by M-ISI score, or increased risk of recurrent UTIs in selected MS patients with LUTS.

The Journal of urology. 2018 Apr 24 [Epub ahead of print]

Elizabeth Dray, Anne Pelletier Cameron, J Quentin Clemens, Yongmei Qin, Diana Covalschi, John Stoffel