Chronic Urinary Retention

Question 1

Chronic Urinary retention defined as

Answer 1

painless, palpable and percussible bladder after voiding

Question 2

Main cause of Chronic Urinary retention

Answer 2

Bladder Failure or Longstanding BOO or Urethral Stricture

Question 3

Immediate Treatment for Chronic Urinary Retention

Answer 3

Catheter

Question 4

Pathological Diuresis Features

Answer 4

Urine Output >200
Postural Hypotension
Weight Loss
Electrolytes

Question 5

What is Postural Hypotension

Answer 5

Systolic Differential >20mm Hg between Lying and Standing

Question 6

Management of Chronic Urinary Retention

Answer 6

IV Fluids

Catheter

Question 7

Residuals in Chronic Urinary retention vary from what to what

Answer 7

400ml to 2 Litres

Question 8

How does chronic urinary retention present

Answer 8

LUTS or Complications eg UTI, Stones, Incontinence or Incidental Finding

Question 9

What occurs at severe end of chronic urinary retention

Answer 9

Overflow incontinence and renal failure when bladder capacity reached and bladder pressure in excess of 25cm water

Question 10

Complications of Chronic Urinary Retention

Answer 10

UTI
Post Decompression Haematuria
Pathological Diuresis
Electrolyte Abnormalities eg Hyponatraemia, Hyperkalcaemia, Metabolic Acidosis
Acute Tubular Necrosis

Question 11

Physiological Diuresis classified as

Answer 11

<200ml/hour

Question 12

Management for Chronic Urinary Retention

Answer 12

I

Long Term Urethral or Suprapubic Catheter

CISC or TURP if BPO

Question 13

Management of Pathological diuresis

Answer 13

IV Fluids (90% of Output) then Catheter, CISC or Turp