Chapter 92: Acute Urinary Retention

Question 1

Pathophysiology necessary for successful voiding

Answer 1

The contraction of bladder detrusor muscle (by cholinergic muscarinic receptors) and relaxation of both the internal sphincter of the bladder neck and the urethral sphincter (through α-adrenergic inhibition)

Question 2

Insertion site of suprapubic catheterization

Answer 2

The insertion site should be 3 to 4 cm superior to the pubic symphysis in the midline

Question 3

How to do obturator technique?

Answer 3

Obturator needle inside the catheter with tip 2.5mm beyond the catheter. After entering the bladder, advance the obturator/catheter for 3cm then unlock obturator and advance catheter for 5cm more

Question 4

This technique uses the Seldinger technique for catheter insertion

Answer 4

Peel-Away Sheath Technique

Question 5

After catheterization, monitor how many hour and ml of urine?

Answer 5

Monitor for 4 hours minimum for significant hourly urinary output (>200 mL/h over intake) after initial return

Question 6

Exert effects on the bladder neck and prostate, may relax bladder smooth muscle, reducing outlet resistance to urinary flow

Answer 6

α-adrenergic receptor antagonists

Question 7

Sample α-adrenergic receptor antagonists

Answer 7

• Alfuzosin, 10 milligrams daily

- Tamsulosin, 0.4 milligram daily

Question 8

Feelings of urgency or bladder spasm can be treated with

Answer 8

Oxybutynin, 2.5mg PO BID or TID