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Quality improvement project: Optimal post-void residual urine volume to guide intermittent catheterization in hospitalised older persons with acute retention of urine.

INTRODUCTION
There is no consensus on the optimal postvoid residual urine volume (PVRU) as a cut-off value prior to performing intermittent catheterisation (IMC). We did a quality improvement project to determine a reasonable PVRU for use in the hospital setting.


MATERIALS AND METHODS
All patients admitted to the five geriatric medicine wards in a geriatric department over a 5- month period who developed acute retention of urine were included in the project. Patients who had hydronephrosis or were already on catheter for more than a week were excluded. Patients included were randomised to PVRU of 200 ml or 300ml. The male and female participants were randomised into separate groups. The primary outcome measures were success in weaning off IMC and the development of urinary tract infection (UTI). The secondary outcomes were the frequency of IMC required and the days needed to wean off IMC successfully.


RESULTS
Both the 200 ml and 300 ml groups had equal success in weaning off IMC and were equally likely to be associated with UTI. However, the 200-ml group had more IMC done within the first 3 days (3.3, SD 2.4 vs 2.4, SD 1.6, p = 0.030), but was weaned off IMC earlier (3.5, SD 1.7, vs 4.8, SD 2.3 days, p = 0.049).


CONCLUSION
We conclude that PVRU of 200 ml or 300 ml are both reasonable cut-off values prior to performing IMC.