Acute urinary retention

Question 1

Etiology

Answer 1

1. Prostatic obstruction
2. Urethral strictures
3. Anticholinergics
4. ‘Holding’
5. Constipation
6. Post operative
7. Infection
8. Neurological
9. Malignancy

Question 2

Eamination

Answer 2

1. Abdomen, identify palpable bladder
2. PR
3. Perineal sensation

Question 3

Investigations

Answer 3

1. FBC
2. UEC
3. Urinalysis
4. Bladder scan, with residual
5. Renal USS if impaired renal

Question 4

Tricks to aid voiding

Answer 4

Analgesia
Privacy
Ambulation
Standing to void
Void to the sound of running water

Question 5

Acute management

Answer 5

1. Catheterise
2. If in clot retention->need 3 way catheter with irrigation
3. Will need trial of void before ceasing catheter

Question 6

Symptoms of chronic retention

Answer 6

1. Overflow incontinence
2. Acute on chronic retention
3. Lower abdominal mass
4. UTI
5. Renal failure

Question 7

Etiology of chronic urinary retention

Answer 7

1. Prostatic enlargement
2. Pelvic malignancy
3. Rectal surgery
4. DM
5. CNS

Question 8

Indications to catheterise in chronic

Answer 8

1. Infection
2. Pain
3. Renal impairment