5.2. Urinary Retention - Chronic

Question 1

What is Chronic Urinary Retention?

Answer 1

A Painless, Palpable and Percussible mass after voiding.

Question 2

What is the main Aetiological Factor for Chronic Urinary Retention?

Answer 2

1. Detrusor underactivity (primary or secondary) due to longstanding bladder outflow obstruction

Question 3

What are the Clinical Features of Chronic Urinary Retention?

Answer 3

1. The Ability to Void
2. Asymptomatic
3. Lower Urinary Tract Symptoms (LUTS)
4. Urinary Tract Infection - this can be a cause and a complication
5. Pathological Diuresis

Question 4

What are the Lower Urinary Tract Symptoms (LUTS)?

Answer 4

1. Incomplete Emptying
2. Increase in Frequency
3. Increase Intermittency
4. Increase Urgency
5. Weak Stream
6. Increased Straining
7. Nocturia

Question 5

What is Pathological Diuresis?

Answer 5

1. A low urine output
2. Postural Hypertension
3. Weight loss
4. Electrolyte Abnormalities

Question 6

What can occur in severe Chronic Urinary Retention?

Answer 6

1. Overflow incontinence

2. Renal failure

Question 7

What investigations are necessary in Chronic Urinary Retention?

Answer 7

1. General (including Digital Rectal) Examination

2. Catheterisation

Question 8

What will be found on General (including Digital Rectal) Examination?

Answer 8

1. Palpable and Percussable Bladder

2. Enlarged Prostate

Question 9

What will catheterisation provide?

Answer 9

If this relieves the symptoms and allows urine flow then is it indicative

Question 10

What treatments are necessary for Chronic Urinary Retention?

Answer 10

1. Catheterisation
2. Clean Intermittent Self-Cathetersation (If appropriate)
3. Trans-Urethral Resection of the Protate - if above fails (this is less successful than acute)