Post-Void Residual Urine: Causes and Solutions

Post-void residual sensation and urinary retention?

Doctor, I previously experienced severe urinary frequency and a significant feeling of incomplete bladder emptying.
I consulted a physician who diagnosed me with cystitis and a urinary tract infection.
After taking antibiotics for 12 days, my urinary frequency improved, but I still have the sensation of incomplete emptying and occasionally pass one or two drops after urination.
I then switched medications and took another course for 12 days, but there was still no improvement.
I went to a larger hospital for a urinalysis, and the doctor said the results were normal, so no medication was prescribed, and I was sent on my way.
This feeling of incomplete emptying sometimes disappears on its own, but at other times it reappears after urination, which has been troubling my daily life for a while.
It particularly makes it difficult for me to fall asleep at night.
I would like to ask the doctor what this symptom could be, what methods might improve it, and if there are any further tests that can be done.
Thank you.

Lin Hao, 20~29 year old female. Ask Date: 2020/03/23

Dr. Cai Zhuorong reply Urology

After recovering from a urinary tract infection, it is possible to still experience temporary urinary discomfort.
Your symptoms may also indicate a recurrence or a chronic infection, or they could be caused by other urinary dysfunctions.

Reply Date: 2020/03/23

More Info

Post-void residual urine (PVR) refers to the amount of urine that remains in the bladder after urination. It is a common issue that can significantly affect a person's quality of life, especially when accompanied by symptoms such as frequent urination and a sensation of incomplete bladder emptying. Your experience of having a persistent feeling of residual urine after treatment for bladder inflammation and urinary tract infection (UTI) is not uncommon, and there are several potential causes and solutions to consider.

Causes of Post-Void Residual Urine
1. Bladder Dysfunction: Conditions such as bladder overactivity or underactivity can lead to incomplete emptying. In your case, bladder inflammation may have caused temporary changes in bladder function, leading to the sensation of residual urine.

2. Obstruction: An obstruction in the urinary tract, such as an enlarged prostate in men or urethral stricture, can prevent complete bladder emptying. Although you mentioned that your urine tests were normal, it might be worthwhile to consider imaging studies to rule out anatomical issues.

3. Neurological Conditions: Certain neurological disorders can affect bladder control and sensation. If you have any history of neurological issues, this could be a contributing factor.

4. Medication Side Effects: Some medications can affect bladder function. If you are taking any medications, it may be worth discussing with your doctor whether they could be contributing to your symptoms.

5. Psychological Factors: Anxiety and stress can also lead to urinary symptoms, including the sensation of incomplete emptying. If you find that your symptoms worsen during stressful times, this could be a contributing factor.

Solutions and Management
1. Bladder Training: This involves scheduled voiding and gradually increasing the time between urinations to help retrain your bladder. Keeping a bladder diary can help identify patterns and triggers.

2. Pelvic Floor Exercises: Strengthening the pelvic floor muscles can improve bladder control and reduce the sensation of residual urine. Kegel exercises are commonly recommended for this purpose.

3. Medications: If bladder overactivity is suspected, medications such as anticholinergics or beta-3 agonists may be prescribed to help relax the bladder and improve symptoms.

4. Further Evaluation: If your symptoms persist, further evaluation may be warranted. This could include:
- Urodynamic Testing: This assesses how well the bladder and urethra are functioning and can provide insight into the cause of your symptoms.

- Cystoscopy: A procedure that allows direct visualization of the bladder and urethra to check for abnormalities.

- Imaging Studies: Ultrasound or CT scans can help identify any structural issues in the urinary tract.

5. Lifestyle Modifications: Staying hydrated, avoiding bladder irritants (like caffeine and alcohol), and managing fluid intake before bedtime can help reduce nighttime symptoms and improve overall bladder health.

6. Follow-Up Care: Regular follow-up with your healthcare provider is essential to monitor your symptoms and adjust treatment as necessary. If your current provider is not addressing your concerns, seeking a second opinion from a urologist may provide additional insights and treatment options.

Conclusion
The sensation of residual urine can be frustrating and disruptive to daily life. It is essential to work closely with your healthcare provider to explore the underlying causes and develop a tailored management plan. With appropriate interventions, many individuals experience significant improvement in their symptoms and quality of life. If your symptoms persist or worsen, do not hesitate to seek further evaluation and support.

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