An elevated PVR in men often signifies an enlarged prostate gland. In both men and women, elevated PVR can indicate a neurological disorder that impairs bladder contraction. An elevated PVR should also prompt the provider to once again carefully review the medication list, looking for agents that tnterfere with bladder contraction (e.g.,anticholinergics) or sphincter relaxation (e.g., alphaadrenergic agonists or betaadrenergic antagonists) lf on reversible causes are identified, and if the patient has on conditions requiring further evaluation, including a normal PVR, the provider can proceed with confidence to the next step-which is to use the patient`s symptoms to distinguish urge from stress incontinence.