Post-Op Retention Flashcards
What is acute urinary retention (AUR)?
A symptomatic inability to completely empty the bladder
Is AUR common in post-op surgical patients?
Relatively
What are the most common diagnostic signs or symptoms of AUR?
- Little or no urine passed in post-op period
- Sensation of needing to void, without being able to micturate
- Suprapubic mass that is dull to perufssion
When may urinary retention be painless?
In patients with previous chronic urinary retention
What should patients presenting with urinary retention be assessed for?
Any underlying causes
What are the common causes of post-op AUR?
- Uncontrolled pain
- Constipation
- Infection
- Anaesthetic agents
What are the risk factors for post-op AUE?
- Age >50
- Male gender
- Previous retention
- Type of surgery
- Anaesthetic type
- Neurological or urological co-morbidities
- Medication
What anaesthetic types are more likely to cause AUR?
- Spinal
- Epidural
What types of surgery are more likely to cause AUR?
- Pelvic
- Urological
What medications are risk factors for AUR?
- Anti-muscarinics
- Alpha agonists
- Opiates
What is the main investigation for AUR?
Ultrasound bladder scan to identify post-void residual urine volume
What should be checked for in AUR?
- Potential underlying reversible causes
- Adequate pain control
- Renal function
Why should renal function be checked in AUR?
Worsening renal function may suggest a high-pressure retention that is impacting renal function
Why can a conservative approach be taken in many patients with AUR?
The majority of post-op urinary retention will resolve spontaneously given time and withdrawal of causative agents
What will be required for any significant urinary retention?
Catheterisation
