Acute urinary retention Flashcards
1
Q
Name an obstructive cause of acute urinary retention
A
- BPH (commonest)
- Urethral strictures
- Massess
- Calculi
- Constipation
- Cystocele
2
Q
Name a medication cause of acute urinary retention
A
- Oxybutynin and other antimuscarinics
- TCAs
- Antihistamines
- Opioids
- Benzodiazepines
3
Q
Name 2 features of acute urinary retention, and which of these are different from how chronic urinary retention presents?
A
- Pain (chronic is usually painless)
- Inability to pass urine
- Lower abdo discomfort
- Acute confusional state especially in elderly
4
Q
Which 2 tests are most important?
A
- U&Es
- Urine sample (may only be possible after catheterisation)
5
Q
What investigation confirms the diagnosis?
A
Bladder US
6
Q
How is it managed?
A
Decompressing bladder with catheterisation
7
Q
After catheterisation, after 15 minutes how much urine should be drained for it to be classed as acute urinary retention?
A
At least 200mls
8
Q
The main complication is post-obstructive diuresis - what is this?
A
Excessive fluid loss following drainage of acute urinary retention due to loss of medullary concentration gradient
