Acute Urinary Retention Flashcards
What is acute urinary retention?
Sudden development in the inability to pass urine
How long does acute urinary retention need to last to be diagnosed?
Period of hours
Who does acute urinary retention usually affect?
Older men
What is the main cause of acute urinary retention?
Benign prostatic hyperplasia
How much urine needs to be retained to be diagnosed?
300ml
What are other possible causes of acute urinary retention?
- Urethral obstruction- strictures, constipation, masses, calculi, cystocele
- Drugs
- UTI
- postoperatively
- postpartum women
What medications can cause acute urinary retention?
- Anti-cholinergic
- Tricyclic anti-depressants
- Antihistamines
- Benzodiazepines
- Alcohol
(affect nerve signals to bladder)
How does acute urinary retention present?
- Inability to pass urine
- Lower abdominal pain
- Confusion in elderly
- Sensation of needing to pee but cant
What can acute urinary retention cause in the elderly?
Confusion
What are the main signs of acute urinary retention?
- Palpable distended bladder
- Lower abdominal tenderness
What is the main diagnostic tool for acute urinary retention?
Bladder ultrasound scan
What other ways can acute urinary retention be diagnosed?
- Urinalysis
* FBC and CRP
What investigation would you carry out in an elderly person presenting with acute urinary retention?
PR examination
What is the main management for acute urinary retention?
Decompress with catheter
What is a possible complication of acute urinary retention?
Post-obstructive diuresis
abnormal condition of prolonged polyuria
Why would you check Serum U&Es and creatinine in someone preseting with acute urinary retention?
To check for kidney injury
Why would you carry out a FBC and CRP in someone preseting with acute urinary retention?
To look for infection
Why would you not check PSA in someone with acute urinary retention?
PSA will be raised due to urinary retention
What examination should all men and women have presenting with acute urinary retention?
Rectal and neurological examination
What examination should all women presenting with acute urinary retention have?
Pelvic examination
What test would you do for post obstructive diuresis?
Serum creatinine
What does urethral obstruction include?
Strictures
Constipation
Masses
Calculi
Cystocele
What are possible complications of acute urinary retention?
- UTI
- post-decompression haematuria
- Post obstructive diuresis
- Electrolyte imbalance
What does a volume of less than 200ml confirm?
Patient didn’t have acute urinary retention
What does a volume of more than 400ml confirm?
Patient has acute urinary retention- catheter should be left in place
What is the most serious complication of acute urinary retention?
Post obstructive diuresis
What is post obstructive diuresis?
Excessive salt and water loss after drainage and decompression of distended bladder
Can worsen AKI
Give IV fluids
