Residual urine

Increased post-void residual urine volume (more than 50 mL)... 

Post-void residual urine Measurement of urine left in Post-void residual urine volume Post-void residual urine volume greater... 

Postvoid residual urine volume Amount of urine left in the urinary bladder after the patient has been asked to empty the bladder. Assessed by urethral catheterization or ultrasonography. Normal postvoid residual urine volume should be less than 50 mL. An increased postvoid residual urine volume is consistent with incomplete bladder emptying. 

Peak urinary flow rate <10 mL/s Postvoid residual urine volume >25-50 mL Increased BUN and serum creatinine All of the above signs plus obstructive voiding symptoms and irritative voiding symptoms (signs of detrusor instability)... 

Objective measures of bladder emptying (e.g., uroflowmeter and postvoid residual urine volumes) are also useful after 6 to 12 months of 5a-reductase inhibitor therapy or 3 to 4 weeks of a-adrenergic antagonist therapy. 

Patients with UUI and elevated postvoid residual urine volume should be treated by intermittent self-catheterization along with frequent voiding between catheterizations. 

Other conditions in which ephedra is contraindicated are anxiety disorders, angle-closure glaucoma, prostate adenoma with residual urine volume, pheochromocytoma, and thyrotoxicosis (Gruenwald et al. 1998). Known medications that may interact adversely with ephedrine include heart glycosides, halothane, guanethidine, MAO inhibitors, secale alkaloids, and oxytocin. 

Tolterodine has a pronounced effect on bladder function in healthy volunteers. The main effects following a 6.4 mg single dose of tolterodine were an increase in residual urine, reflecting an incomplete emptying of the bladder, and a decrease in detrusor pressure. 

Early urodynamic effect. Permixon was administered to 75 patients with lower urinary tract symptoms resulting from mild-to-moderate BPH (mean IPSS 8.2), aged 52-78 years, at a dose of 160 mg twice daily for 9 weeks. Maximum urinary flow rate increased 6% (p < 0.001), and there was a reduction in detrusor pressure at maximum flow (12.8%, p < 0.001), opening detrusor pressure (12.6%, p < 0.001), and residual urine volume (12.6%, p < 0.05). The IPSS... 

Mechanism of Action A urinary antispasmodic t hat act s as a direct antagonist at muscarinic acetylcholine receptors in cholinergically innervated organs. Reduces tonus (elastictension) of smooth muscle in the bladder and slows parasympathetic contractions. Therapeutic Effect Decreases urinary bladder contractions, increases residual urine volume, and decreases detrusor muscle pressure. 

Monitor the patient for incontinence and residual urine in the bladder... 

The nettle is rich in vitamins A and C and in minerals, particularly iron, potassium, and silica. Modern scientific studies have focused on its diuretic action. It lowers systolic blood pressure by increasing volume, die root treats symptoms of benign prostatic hyperplasia (BPH) by increasing urine flow and reducing residual urine. Nettle herb is also used for bladder irrigation and to prevent and treat bladder and kidney stones (see Chapter 66). 

P. africanum improved specific urinary symptoms and flow measures. In six double-blind trials involving 430 participants, men receiving P. africanum were more than twice as likely to be rated by their physician as having overall improvement in symptoms compared with men taking placebo. P. africanum reduced nocturia compared with placebo. P. africanum also increased peak urine flow compared with placebo. Additionally, P. africanum reduced residual urine volume. 

Although deprived of secreting glandules, the vaginal mucosa is covered with a watery acidic fluid. This fluid includes contributions from vaginal transudation, Bartholin and Skene glands, exfoliated epithelial cells, residual urine, and fluids from... 

OF-Adrenergic antagonists relax the smooth muscle in the prostate and bladder neck, thereby increasing urinary flow rates by 2 to 3 mL/sec in 60% to 70% of patients and reducing postvoid residual urine volumes. Tamsulosin and doxazosin produce durable responses for 6 and 10 years, respectively. 

A 59-year-old man had spinal anesthesia for hallux valgus surgery with 5% hyperbaric Udocaine 75 mg. The next day he had persistent perianal numbness, difficulty in micturition, and a large residual urine volume. An MRI scan was normal and he had reduced perianal and scrotal sensation, difficulty in defecation, and erectile impotence. He was no better 5 months later. 

Residual urine over Residual urine over 50 milliliters 50 milliliters... 

Champault et al. "Medical treatment of Prostatic Adenoma." One hundred and ten patients with a prostatic adenoma that needed medical treatment but did not require surgery were treated in a controlled study. The month-long test was judged on objective (nocturnal pollakiuria, urinary output, residual urine) and subjective criteria (dysuria, patients opinions). Serenoa showed significantly greater effectiveness than placebo and was perfectly tolerated. Supplementary studies in 47 patients with a mean follow-up of 14.6 months showed continued effectiveness and lack of side effects. 

Wilt, T. et al. A recent meta-analysis of randomized controlled studies of using Serenoa to treat BPH was recently published in the Journal of the American Medical Association. The article concluded that patients and physicians rated saw palmetto as superior to the placebo and comparable to Proscar. Serenoa reduced nocturia by 25 percent compared to the placebo and ranked equally with Proscar at improving peak and mean urine flow rates and reducing residual urine. Side effects were comparable to the placebo and did not show the high erectile dysfunction rates associated with the use of Proscar. 

A recent study by Bach, Schmitt, and Ebeling compared three prescriptive medications with a standardized saw palmetto extract. The drugs worked by two different mechanisms. Finasteride is a synthetic 5-alpha-reductase inhibitor, and the other two drugs, terazosin and alfuzosin, are alpha-1 blockers. In all important parameters, the saw palmetto was a comparable treatment with far fewer side effects. It decreased residual urine volume, reduced irritation, and increased urinary flow 80 percent of patients rated their improved quality of life as good to very good. 

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