Acute Urinary Retention Flashcards
What suggests gradually worsening voiding symptoms?
o Hesitancy
o Poor stream
o Incomplete emptying
o Post-micturition dribble
What suggests gradually worsening infection?
o Burning dysuria
o Smelly urine
o Haematuria
What suggests neurological involvement?
o Back pain
o Multiple sclerosis
What suggests gynaecological involvement?
- Period irregularities
- Menopausal bleeding
- Intra-menstrual bleeding
- Abdominal pain and bloating
What medications may cause acute urinary retnetion?
- Opiates
- Anticholiergics
What may you find on examination?
- Palpable bladder which is dull to percussion
- Assessment of perineal and perianal sensation
- Assessment of anal sphincter tone
- Lower limb sensation, tone and reflexes
- Prostate
What immediate intervention must you do in acute urinary retention?
Catheterisation
What investigations would you do for acute urinary retention?
Urinalysis
Men -> PSA
o Catheterisation can slightly raise PSA
Women -> Transvaginal pelvic ultrasound scan
o Look for pelvic masses
MRI
o If worried about cauda equina
What is the treatment if you think the acute urinary retention is due to an enlarged prostate?
Start on alpha blocker before removing catheter
- Tamsulosin
- Doxazosin
What drugs are CI in bladder outflow obstruction and urinary retention?
Anti-cholinergics/anti-muscarinics
