What does a post-void residual volume of 28 cc following a pre-void volume of 163 cc indicate for a patient with Lower Urinary Tract Symptoms (LUTS) and hematuria?

Post-Void Residual of 28 cc: Clinical Interpretation

A post-void residual (PVR) of 28 cc following a pre-void volume of 163 cc is completely normal and indicates excellent bladder emptying function, requiring no intervention. This represents a bladder voiding efficiency of approximately 83% (135 cc voided/163 cc total), which is well within normal parameters.

Normal PVR Parameters

• PVR values under 100 mL are generally considered normal bladder emptying 1, 2
• Your measurement of 28 cc falls well below any threshold of clinical concern 1, 2
• The American Urological Association states that PVR volumes between 0-300 mL do not predict response to medical therapy and do not mandate any specific intervention 3, 1

Clinical Significance in Context of LUTS and Hematuria

• The normal PVR effectively rules out urinary retention or significant bladder outlet obstruction as the cause of your symptoms 3, 4
• In patients with lower urinary tract symptoms (LUTS) and normal PVR, a non-bladder-emptying etiology should be investigated 3
• The hematuria requires separate evaluation and is not explained by the PVR measurement 3

What This Means for Your Evaluation

• No catheterization or bladder drainage intervention is needed - your bladder is emptying efficiently 1, 2
• The focus should shift to investigating other causes of your LUTS symptoms, such as:
  • Bladder overactivity or detrusor overactivity 3
  • Urethral pathology 3
  • Source of hematuria (bladder lesions, stones, infection, malignancy) 3
• Uroflowmetry may be helpful to assess flow patterns if obstruction is still suspected despite normal PVR 3, 5

Important Caveats

• PVR measurements have significant test-retest variability - if there were concern about your bladder emptying, the measurement should be repeated 2-3 times to ensure reliability 1, 2, 4
• However, given your value is so clearly normal (28 cc), repeat measurement is unnecessary 1
• A single normal PVR does not rule out intermittent retention, but your value suggests consistent good emptying 6

Next Steps in Your Workup

• The normal PVR directs attention away from bladder emptying problems and toward other causes of your symptoms 3
• Hematuria workup should proceed with cystoscopy and upper tract imaging as clinically indicated 3
• If LUTS persist, consider evaluation for overactive bladder, prostate issues (if male), or other non-obstructive causes 3