Acute urinary retention

Question 1

Define acute Urinary retention

Answer 1

Painful inability to void with a palpable and percussible bladder’

Question 2

What causes acute Urinary retention

Answer 2

BPO (most common)

UTI, urethral stricture, alcohol excess, post-operative causes, acute surgical or medical problems (It can occur in absence of BPO)

Question 3

How can BPO cause actue urinary retention

Answer 3

Spontaneously (i.e. natural progression of BPO)

Be triggered by an unrelated event (eg. constipation, alcohol excess, post-operative causes, urological procedure)

Question 4

What is the treatment for acute urinary retention

Answer 4

Catheterisation

After catheter is in place – try and treat underlying trigger

If no renal failure, start alpha blocker immediately and remove catheter in 2 days (60% will void successfully); if fail to void, recatheterise and organise TURP (after 6 weeks)

Question 5

If urethral catheterisation is not possible what is the next option

Answer 5

Uprapubic

Question 6

Whats the complications of acute urinary retention

Answer 6

UTI
post-decompression haematuria, 
Pathological diuresis, 
Renal failure, 
Electrolyte abnormalities