Urinary retention

Question 1

Three causes of urinary retention?

Answer 1

Obstructive: BPH, urethral stricture, constipation, peri-operative pain, drugs

Neuological: MS, DM, Spinal injury/compression, pelvic surgery

Myogenic: alcohol, post-anaesthesia

Question 2

Two clinical features of urinary retention?

Answer 2

suprapubic tenderness
palpable bladder- dull to percussion, can’t get beneath it
large prostate
<1L drained on catheterisation

Question 3

Three investigations for urinary retention?

Answer 3

FBC, U+E, PSA
Urine dip
US bladder
Pelvic XR

Question 4

Two management options for urinary retention?

Answer 4

conservative- analgesia
catheterise + TWOC (trial without catheter 24-72 hr)
TURP- failed TWOC, impaired renal function

Question 5

Define hydronephrosis

Answer 5

one or both kidneys become stretched and swollen as the result of a build-up of urine inside them

Question 6

Two advantages to suprapubic catheterisation?

Answer 6

reduced UTIs
avoids urethral stricture formation
patient preference
maintain sexual function