Research Finds No Clear Link Between Post-Void Residual Volume and Urinary Symptoms in Postmenopausal Women
When a postmenopausal patient complains of mild urinary symptoms but has no incontinence or prolapse, should you automatically check her post-void residual (PVR) urine volume? A new exploratory study in BMC Women's Health challenges the routine link between PVR and symptom burden in this growing patient population.
Study Design: Filling a Clinical Knowledge Gap
Researchers enrolled 70 postmenopausal women without urinary incontinence or pelvic organ prolapse. All participants had normal urinalysis, were not on medications affecting the urinary tract, and had no significant comorbidities. The team measured each woman’s PVR using transabdominal ultrasound and assessed symptom burden and quality of life via the King’s Health Questionnaire (KHQ)—a validated instrument primarily for urinary incontinence.
What They Found: No Significant Association
The study divided women into two groups: those reporting no urinary symptoms and those reporting mild to moderate symptoms. Notably, the average PVR was low (38.7 mL), and there was no significant difference in PVR or uroflowmetry parameters between symptomatic and asymptomatic groups. Statistical analysis revealed no significant correlation between PVR volume and any KHQ score—either in the full cohort or within symptom-based subgroups.
Clinical Implications: Rethinking the Role of PVR
For healthy postmenopausal women without incontinence or prolapse, the findings suggest that PVR volume alone may not meaningfully reflect patient-reported symptom burden or overall quality of life. Objective voiding measures and subjective complaints can diverge, especially in low-risk populations. The study also highlights the limitations of tools like the KHQ, which may not capture voiding-phase symptoms such as hesitancy or incomplete emptying.
Limitations and Considerations
The authors stress that this research is exploratory. The cohort was small and highly selective, with little variability in PVR and symptoms. Grouping was based on a single KHQ item, and no adjustments were made for possible confounders. Additionally, the questionnaire focused on incontinence, not voiding dysfunction. As such, the absence of association does not rule out a relationship in broader or higher-risk populations.
Conclusion
For postmenopausal women without significant pelvic floor disorders, PVR volume may have limited value in explaining mild urinary symptoms or predicting quality-of-life impact. Future, larger studies using voiding-specific tools are needed to clarify when and for whom PVR measurements matter most in clinical practice.
KEY POINTS
No significant link was found between PVR volume and urinary symptom burden in postmenopausal women without incontinence or prolapse.
Both symptomatic and asymptomatic groups had similar uroflowmetry and PVR values.
Objective measures like PVR may not always align with patient-reported symptoms in healthy populations.
The King’s Health Questionnaire may not fully capture voiding-specific complaints in this setting.
More robust studies are needed to define the clinical utility of PVR in postmenopausal patients without overt pelvic floor dysfunction.
Citation: Umudova K, Demir Ö. Examination of the relationship between post-voiding residual urine volume and patient-reported urinary symptoms in postmenopausal women. BMC Women's Health. 2026;[Epub ahead of print]. DOI: https://doi.org/10.1186/s12905-026-04626-5
