Abstract
Background
Despite the conflicting evidence about postvoid residual (PVR) and its variation in
time and corresponding voided volume (VV), studies with urinary diaries and systematic
measurements of PVR after each void have never been conducted in nursing home (NH)
residents.
Objective
To describe the circadian rhythm of PVR and residual fraction (RF, the net quantity
of PVR) and to identify the time window with the highest PVR and RF.
Design, setting, and participants
A multicentre prospective study conducted between 2014 and 2015 in 5 Belgian NHs.
A convenience sample of cognitively intact residents completed a 24-hour frequency
volume chart with PVR.
Results
Participants (n = 73) had a median age of 84 years (interquartile range 82-89) and
moderate impairment of activities of daily living; 69% were women.
In residents with nocturia, mean PVR was higher during the night [45 mL (26–80)] than
during the day [36 mL (18–61)]. In residents without nocturia no difference was detected.
In spite of the variation between diurnal and nocturnal VV and PVR in residents with
nocturia, all residents emptied their bladder as effectively during daytime as during
nighttime [mean RF = 20% (12–32)].
Maximum PVR and RF in residents with nocturia (n = 57) showed a circadian variation.
The highest PVR and RF were found during the day. The PVR and RF of the first morning
void were an indicator of the maximum nocturnal PVR and RF.
Conclusions
PVR and VV should be measured in NH residents during the waking hours (first morning
void excepted) to detect the clinically relevant maximum PVR and RF.
Keywords
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Article info
Publication history
Published online: January 17, 2017
Footnotes
The authors declare no conflicts of interest.
Identification
Copyright
© 2016 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
