Urinary retention
From Ganfyd
Has a distinct mortality[1][2] and morbidity
Web Resources for Urinary retention
Relevant Clinical Literature
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Medpedia on Urinary retention (Less technical, good quality control)
Wikipedia on Urinary retention (Less technical, ? quality control)
- inability to pass urine from a filled bladder. Commoner in males than females.
- Acute retention is painful and needs treatment (by catheterisation)
- There is an interesting lack of international consensus after this point[3]
- Chronic retention without renal obstruction (deterioration in renal function) may be best not treated acutely
Contents |
Causes
- Urethral obstruction
- Internal
- Stricture
- Foreign object
- Inflammation
- External
- Prostate (Males)
- Constipation (Females)
- Internal
- Urethral sphincter muscle contraction
- Drugs
- Neurological disease
Treatment
Acute Management
Obstruction
- Urinary catheterisation
- Per-urethra
- Suprapubic catheterisation
- Trial without catheter (TWOC)
- Catheter removal after 1-3 days
- In prostatism 23-40% success rate, about 50% with α1 blocker premed and if done by 3 days[4]
- Prostatectomy
- Emergency prostectomy has higher mortality than elective prostectomy which may be unnecessary with TWOC[5]
Muscle spasm
Sub-acute Managaement
- Remove precipitating cause
- Prostatectomy
- Drugs
- Alphablockers
- Hormone manipulation eg 5α-reductase inhibitors
This article is a stub. Please feel free to expand it and make it more encyclopaedic.
References
- ↑ Armitage JN, Sibanda N, Cathcart PJ, Emberton M, van der Meulen JH. Mortality in men admitted to hospital with acute urinary retention: database analysis. BMJ (Clinical research ed.). 2007 Dec 8; 335(7631):1199-202.(Link to article – subscription may be required.)
- ↑ Pickard R, Emberton M, Neal DE. The management of men with acute urinary retention. National Prostatectomy Audit Steering Group. British journal of urology. 1998 May; 81(5):712-20.
- ↑ Fitzpatrick JM, Kirby RS. Management of acute urinary retention. BJU international. 2006 Apr; 97 Suppl 2:16-20; discussion 21-2.(Link to article – subscription may be required.)
- ↑ Desgrandchamps F, De La Taille A, Doublet JD. The management of acute urinary retention in France: a cross-sectional survey in 2618 men with benign prostatic hyperplasia. BJU international. 2006 Apr; 97(4):727-33.(Link to article – subscription may be required.)
- ↑ Fitzpatrick JM, Kirby RS. Management of acute urinary retention. BJU international. 2006 Apr; 97 Suppl 2:16-20; discussion 21-2.(Link to article – subscription may be required.)
