Acute Urinary Retention Flashcards

1
Q

What is acute urinary retention?

A

Sudden development in the inability to pass urine

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2
Q

How long does acute urinary retention need to last to be diagnosed?

A

Period of hours

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3
Q

Who does acute urinary retention usually affect?

A

Older men

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4
Q

What is the main cause of acute urinary retention?

A

Benign prostatic hyperplasia

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5
Q

How much urine needs to be retained to be diagnosed?

A

300ml

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6
Q

What are other possible causes of acute urinary retention?

A
  • Urethral obstruction- strictures, constipation, masses, calculi, cystocele
  • Drugs
  • UTI
  • postoperatively
  • postpartum women
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7
Q

What medications can cause acute urinary retention?

A
  • Anti-cholinergic
  • Tricyclic anti-depressants
  • Antihistamines
  • Benzodiazepines
  • Alcohol

(affect nerve signals to bladder)

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8
Q

How does acute urinary retention present?

A
  • Inability to pass urine
  • Lower abdominal pain
  • Confusion in elderly
  • Sensation of needing to pee but cant
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9
Q

What can acute urinary retention cause in the elderly?

A

Confusion

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10
Q

What are the main signs of acute urinary retention?

A
  • Palpable distended bladder
  • Lower abdominal tenderness
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11
Q

What is the main diagnostic tool for acute urinary retention?

A

Bladder ultrasound scan

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12
Q

What other ways can acute urinary retention be diagnosed?

A
  • Urinalysis

* FBC and CRP

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13
Q

What investigation would you carry out in an elderly person presenting with acute urinary retention?

A

PR examination

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14
Q

What is the main management for acute urinary retention?

A

Decompress with catheter

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15
Q

What is a possible complication of acute urinary retention?

A

Post-obstructive diuresis

abnormal condition of prolonged polyuria

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16
Q

Why would you check Serum U&Es and creatinine in someone preseting with acute urinary retention?

A

To check for kidney injury

17
Q

Why would you carry out a FBC and CRP in someone preseting with acute urinary retention?

A

To look for infection

18
Q

Why would you not check PSA in someone with acute urinary retention?

A

PSA will be raised due to urinary retention

19
Q

What examination should all men and women have presenting with acute urinary retention?

A

Rectal and neurological examination

20
Q

What examination should all women presenting with acute urinary retention have?

A

Pelvic examination

21
Q

What test would you do for post obstructive diuresis?

A

Serum creatinine

22
Q

What does urethral obstruction include?

A

Strictures
Constipation
Masses
Calculi
Cystocele

23
Q

What are possible complications of acute urinary retention?

A
  • UTI
  • post-decompression haematuria
  • Post obstructive diuresis
  • Electrolyte imbalance
24
Q

What does a volume of less than 200ml confirm?

A

Patient didn’t have acute urinary retention

25
Q

What does a volume of more than 400ml confirm?

A

Patient has acute urinary retention- catheter should be left in place

26
Q

What is the most serious complication of acute urinary retention?

A

Post obstructive diuresis

27
Q

What is post obstructive diuresis?

A

Excessive salt and water loss after drainage and decompression of distended bladder
Can worsen AKI
Give IV fluids