acute urinary retention Flashcards
what
sudden inability to voluntarilty pass urine
causes
BPH uretheral strictures calculi cystocele constipation massess certain medications neurological causes post partum in women
which drugs can cause urinary retention
tricyclic antidepressants e.g. amitryptiline anticholinergics opiods NSAIDs disopyramide
presentation
subacute onset of
- inability to pass urine
- lower abdo pain
- acute confusional state in elderly patients
how does acute differ from chronic urinary retention
chronic is typically paonless
OE
palpable distended bladder on either abdo or rectal exam
lower abdo tenderness
Ix
urinarlysis
U&Es
creatiine
FBC, CRP
why is PSA not appropriat
will be elevated in acute urinary retentsion anyway
confirming diagnosis
bladder USS
volume >300cc
management
decompressing bladder via catheterisation
volume measurement after catheterisation
volume drained in 15min measures
<200 confirms they dont have acute retention
> 400 confirms diagnosis and means catheter should be left in place
complication
post-obstructive diuresis
can lead to volume depletion and worsening AKI
may need IV fluids
