Acute Urinary Retention

Question 1

what is it?

Answer 1

sudden inability to pass urine, requires URGENT CATHETERISATION

medical emergency

Question 2

causes?

Answer 2

• obstruction
  
  • BPH/ prostate cancer
  • women- prolapse, pelvic mass ie fibroids
  • urethral stricture
  • constipation
• inflammatory
  
  • balanitis, prostatitis, vulvovaginitis
  • sepsis
• drugs
  
  • anticholinergics
  • alcohol
  • spinal /epidural
  • opioids
  • alpha agonists, CCBs
• neurogenic
  
  • CES
  • MS

Question 3

Ix?

Answer 3

• Bloods
  
  • FBC, U&E, PSA
• Imaging
  
  • if U&E abnormal –> USS KUB (hydronephrosis)
  • CT (abdo/pelvic mass) / MRI head for neuro cause

Question 4

Mx?

Answer 4

immediate catheterisation

• 3 way if clots

Question 5

what may happen post catheterisation?

Answer 5

post obstructive diuresis

Question 6

How do you assess a pt in retention?

Answer 6

• History
  
  • Symptoms of CES
  • LUTS
  • pain
  • red flags
    
    • wt loss
    • bone pain
    • haematuria
• Examination
  
  • abdo
  • DRE
  • +/- neuro