Post-Void Residual Test: Is Your Bladder Empty?

Ever have that nagging feeling? You just went to the bathroom, but it feels like your bladder didn’t quite get the memo? Or maybe you’re making more trips than you’d like, and it’s starting to get frustrating. I see this in my clinic, and it’s often a sign we need to take a closer look at how well your bladder is emptying. One of the ways we can do that is with a Post-Void Residual Urine Test.

So, what exactly is this test? “Post-void residual” – it sounds a bit technical, I know. We often call it PVR for short. It simply means the amount of urine, or pee, that’s left hanging out in your bladder right after you’ve tried to empty it. Think of it like this: when you go, your bladder should pretty much empty out completely. But sometimes, for various reasons, some urine stays behind. A little bit is usually no big deal, but if there’s a lot left, that’s called urinary retention, and it can tell us there might be an underlying issue we need to address.

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Why Might We Suggest This Test?

You might be wondering if this test is something you need. Well, if you’ve been telling me about things like:

Feeling like you have to pee all the time.
Unexpected leaks, what we call incontinence.
Getting those pesky urinary tract infections (UTIs) more often than you’d like.
That persistent feeling that your bladder isn’t truly empty after you go.
Or if we’ve found bladder stones.

…then a Post-Void Residual Urine Test can give us some really valuable clues.

How is a Post-Void Residual Urine Test Done?

Okay, so how do we actually measure this leftover urine? There are a couple of common ways we do this, and neither is too complicated.

The two main methods are:

Bladder Catheterization: Now, I know the word ‘catheter‘ can sound a bit intimidating. It’s just a thin, flexible tube. First, you’ll go to the bathroom and empty your bladder as much as you can. Then, you’ll lie back comfortably on an exam table. We’ll clean the area around your urethra (that’s the little tube pee comes out of) and use a local anesthetic to numb it up, so it’s as comfortable as possible. Then, we gently slide the catheter through the urethra and into your bladder. Any urine that was left behind will drain out through the tube, and we’ll measure exactly how much there is. Then, out comes the catheter, and you’re done. Simple as that.

Ultrasound: This method is completely non-invasive, meaning nothing goes inside your body. Again, you’ll empty your bladder first. Then, you’ll lie back.

For a bladder scan, we’ll put a bit of cool gel on your lower belly and then a special probe, kind of like a microphone, is moved over the area. This probe uses sound waves – you can’t feel them – to create pictures of your bladder on a screen. From these pictures, we can calculate how much urine is still in there.

Sometimes, especially for women, we might use a transvaginal ultrasound. The probe is a bit different and is gently placed into the vagina to get a clearer view of the bladder.

You usually don’t need to do anything special to prepare for a Post-Void Residual Urine Test. You can typically eat and drink normally. But, it’s always a good idea to just double-check with us if there are any specific instructions for you.

After the test, you can usually get right back to your day. If you had the catheter, you might feel a little bit of discomfort when the numbing wears off. Drinking plenty of water and peeing a few times usually helps that settle down.

Are There Any Risks?

With any procedure, even simple ones, there can be small risks. For the bladder catheterization method, these are pretty uncommon, but they can include:

A slight risk of a urinary tract infection (UTI). Sometimes we might give you an antibiotic to help prevent this.
Seeing a little blood in your urine (we call this hematuria).
Very rarely, some irritation or damage to the urethra or bladder.

The ultrasound method doesn’t carry these risks because it’s done on the outside of your body. It’s quite straightforward.

What Do the Results Mean?

So, what are we looking for? The results of your Post-Void Residual Urine Test will tell us the volume of pee left in your bladder. Generally, a normal amount is somewhere between 50 milliliters (mL) and 100 mL – that’s not very much, maybe a few tablespoons. If the amount is higher, it tells us your bladder isn’t emptying as well as it should.

We usually get the results pretty quickly, often right away.

What if My PVR Volume is High?

If you do have a high PVR volume, it means we need to figure out why. There are a few common culprits:

A blockage somewhere in your urinary tract – this could even be from things like tumors, though that’s less common.
An enlarged prostate (this is a common one for men).
Side effects from certain medications.
A narrowed urethra.
Nerve issues that affect bladder control, sometimes called a neurogenic bladder.

Don’t worry, though. If your PVR is high, it’s just the next step in figuring things out. The treatment will depend entirely on what’s causing the problem. It could involve medications, sometimes procedures, or even surgery in certain cases. We’ll sit down and talk through all the options for you. We’ll make sure you understand everything.

When Should I Reach Out?

Of course, if you suddenly find you can’t pee at all, that’s an emergency, and you should head to the ER right away.

But also, give us a call if you notice:

Pain or swelling in your belly.
Pain when you’re peeing.
A fever.
Your pee looks cloudy or has a strong, bad smell.

Key Things to Remember About Your Post-Void Residual Urine Test

Here’s a quick rundown of what we’ve talked about:

A Post-Void Residual Urine Test (PVR test) measures how much urine is left in your bladder after you pee.
It helps us understand if you’re having trouble emptying your bladder completely, a condition called urinary retention.
Common reasons for the test include frequent urination, leakage, recurrent UTIs, or feeling like your bladder isn’t empty.
The test is usually done with a bladder catheter or an ultrasound – both are straightforward procedures.
A normal PVR is typically under 100 mL. A high PVR means we’ll look for underlying causes like blockages, enlarged prostate, medication side effects, or nerve issues.
Treatment for high PVR depends on the cause, and we’ll discuss all your options for your Post-Void Residual Urine Test results.
If you can’t pee at all, seek emergency care. Call us for symptoms like abdominal pain, painful urination, fever, or cloudy/foul-smelling urine.

Dealing with bladder issues can be really disruptive, I get it. But finding out what’s going on is the first step to feeling better. You’re not alone in this, and we’re here to help you through it.