Do subjective symptoms of obstructive voiding correlate with post-void residual urine volume in women?

The objective was to determine if symptoms of obstructive voiding correlate with post-void residual urine volume measured by catheterization. A cross-sectional study of 134 consecutive women referred to a tertiary urogynecology clinic was performed. Subjects were interviewed regarding three types of obstructive voiding symptoms: a sensation of incomplete emptying, straining to void, and slow urine stream. Post-void residual urine volume was measured by catheterization as the gold standard. Data for each symptom were analyzed using Cohen's kappa test, sensitivity, specificity, likelihood ratios for a positive of negative test, and positive and negative predictive values. A total of 11 out of 134 patients (8%) had a post-void residual volume greater than 100 ml. Of these 11, 1 had symptoms of incomplete emptying (9%), 1 had symptoms of straining to void (9%), and 2 had symptoms of slow urine stream (18%). Sensitivity, specificity, likelihood ratio for a positive symptom, likelihood ratio for a negative symptom, positive predictive value, negative predictive value, and Cohen's kappa, respectively, were 9%, 80%, 0.47, 1.13, 4%, 91%, and 0.05 for the symptom of incomplete emptying, 9%, 91%, 1.12, 1.0, 8%, 92%, and 0.01 for straining to void, and 18%, 89%, 1.6, 0.92, 13%, 92%, and 0.07 for the symptom of slow urine stream. It was concluded that symptoms of obstructive voiding do not correlate with measured post-void urine volume. In clinically important situations, these symptoms cannot substitute for measurement of post-void residual urine volume.