AIM: It remains unclear why patients suffer from a feeling of incomplete emptying despite no or little post-void residual (PVR). Accordingly, we evaluated the clinical implications thereof in men with lower urinary tract symptoms (LUTS). METHODS: Records were obtained from a prospectively maintained database for 905 first-visit men with LUTS. Patients with comorbidities that may affect voiding function and with PVR > 20 ml were excluded. Finally, 421 patients were eligible for the study. RESULTS: By International Prostate Symptom Score (IPSS), a score for evaluating a feeling of incomplete emptying, 106 patients (25.2%) were characterized as experiencing no symptoms (score 0, 1), 201 (47.7%) as mild to moderate symptoms (score 2, 3), and 114 (27.1%) as severe symptoms (score 4, 5). The severity of a feeling of incomplete emptying was significantly associated with total IPSS and with subscores for both voiding and storage symptoms (P < 0.001). Comparing patients with severe symptoms (severe group, N = 114) with a propensity score-matched control group, adjusting for age, PVR, and maximum flow rate, total IPSS was significantly different between the two groups (23.04 ± 5.68 vs. 13.21 ± 5.48, respectively; P < 0.001). The subscores for both voiding and storage symptoms were also significantly worse in the severe group. The quality of life score was 4.51 ± 0.80 in the severe group and 3.53 ± 1.05 in control group (P < 0.001). CONCLUSIONS: A feeling of incomplete emptying despite little PVR was frequently observed and, notably, this was significantly associated with worsening of both voiding and storage symptoms, even after adjusting for relevant variables.
AIM: It remains unclear why patients suffer from a feeling of incomplete emptying despite no or little post-void residual (PVR). Accordingly, we evaluated the clinical implications thereof in men with lower urinary tract symptoms (LUTS). METHODS: Records were obtained from a prospectively maintained database for 905 first-visit men with LUTS. Patients with comorbidities that may affect voiding function and with PVR > 20 ml were excluded. Finally, 421 patients were eligible for the study. RESULTS: By International Prostate Symptom Score (IPSS), a score for evaluating a feeling of incomplete emptying, 106 patients (25.2%) were characterized as experiencing no symptoms (score 0, 1), 201 (47.7%) as mild to moderate symptoms (score 2, 3), and 114 (27.1%) as severe symptoms (score 4, 5). The severity of a feeling of incomplete emptying was significantly associated with total IPSS and with subscores for both voiding and storage symptoms (P < 0.001). Comparing patients with severe symptoms (severe group, N = 114) with a propensity score-matched control group, adjusting for age, PVR, and maximum flow rate, total IPSS was significantly different between the two groups (23.04 ± 5.68 vs. 13.21 ± 5.48, respectively; P < 0.001). The subscores for both voiding and storage symptoms were also significantly worse in the severe group. The quality of life score was 4.51 ± 0.80 in the severe group and 3.53 ± 1.05 in control group (P < 0.001). CONCLUSIONS: A feeling of incomplete emptying despite little PVR was frequently observed and, notably, this was significantly associated with worsening of both voiding and storage symptoms, even after adjusting for relevant variables.
Authors: Yassine Kamal Lyauk; Daniël M Jonker; Trine Meldgaard Lund; Andrew C Hooker; Mats O Karlsson Journal: AAPS J Date: 2020-08-27 Impact factor: 4.009