Factors Associated with Incomplete Bladder Emptying in Older Women with Overactive Bladder Symptoms

Abstract

OBJECTIVES: To identify factors associated with incomplete bladder emptying in older women with overactive bladder (OAB) symptoms. DESIGN: Retrospective medical records review. SETTING: Urodynamic laboratory at a large academic health care system in the southeast United States. PARTICIPANTS: Medical records from women aged 65 and older who presented to clinic with OAB symptoms and who had completed outpatient urodynamic testing (N = 203). MEASUREMENTS: Three cutoff values of postvoid residual (PVR) volume (100, 150, 200 mL) were created a priori to classify incomplete bladder emptying. Age; vaginal parity; diabetes mellitus (DM); and a history of cerebrovascular accident, back surgery or injury, pelvic surgery, anti-urinary incontinence surgery, and pelvic organ prolapse were included in univariate and multivariate logistic regression models to determine factors associated with incomplete bladder emptying. RESULTS: When PVR volume of 200 mL or greater was used to define incomplete bladder emptying, history of back surgery or injury (odds ratio (OR) = 4.30, 95% confidence interval (CI) = 1.16-15.91) and pelvic surgery (OR = 4.42, 95% CI = 1.51-12.95) were significantly associated with incomplete bladder emptying in multivariate analysis. No factors were significantly associated with PVR volumes of 100 mL or greater or 150 mL or greater. CONCLUSION: PVR volumes should be assessed in older women with OAB symptoms and a history of back surgery or injury or pelvic surgery, especially before the administration of antimuscarinic medications. Caution in interpreting these findings is needed because PVR volumes obtained from pressure-flow studies may differ from those obtained from natural voiding. Lack of data on medications that can contribute to incomplete bladder emptying and the small number of women with cerebrovascular accident, back surgery or injury, and DM may have influenced the results.