URINARY RETENTION Flashcards

1
Q

What is urinary retention

A

Inability to voluntarily urinate

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2
Q

What are the causes?

A
  • urethral blockage
  • medication
  • conditions that intefere with relaxation fo the urethra
  • neurogenic causes
  • postpartum
  • post op
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3
Q

What medication can cause urinary retention?

A

antimuscairnic
sympathomimetics
tcas

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4
Q

Acute urinary retention

A

medical emergency
abrupt development over a period of hours

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5
Q

Chronic urinary retention

A

gradual over months
inability to completely empty bladder

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6
Q

Benign prostatic hyperplasia

A

most common cause in men -enlarged prostate

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7
Q

Symptoms of BPH

A

urinary retention
urgency
frequency and nocturia

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8
Q

Acute urinary retention treatment

A

immediate catheterisation due to the pain
provide alpha-blocker for 2 days before removing catheter

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9
Q

Alpha-blockers example

A

Alfuzosin
Doxazosin
Tamsulosin
Terazosin
Indomarin
Prazosin

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10
Q

Chronic urinary retention treatment

A

catheter used long term
may cause recurrent UTIs, urethra trauma, pain and stone formation

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11
Q

catheter associated UTI treatment frequency

A

7 days

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12
Q

BPH treatment

A
  1. alpha-blocker
  2. if raised prostate antigens, or at high risk of progression = finasteride or dutasteride
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13
Q

Alpha-blockers MOA

A

Relax smooth muscles in BPH = increase in urinary flow rate and improvement in obstructive symptoms

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14
Q

5a-reductase inhibitor

A

finasteride
dutasteride

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15
Q

avoid alpha blockers in

A

history of:
micturition syncope
postural hypotension

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16
Q

side effects of alpha blockers

A
  • dizziness, postural hypotension
  • first dose may cause collapse due to hypotensive effect
  • take before bed
  • lie down if dizziness, fatigue or sweating develop until they feel better
17
Q

5a-reductase side effects

A

breast disorder
sexual dysfunction
male breast cancer reported
finasteride: reports of depression and rare cases of suicidal thoughts

18
Q

Male breast cancer

A

report lumens, pain or nipple discharge

19
Q

5a-reductase inhibitors and women

A
  • excreted in semen - use condom, if partner is pregnant or likely to become pregnant
  • women of childbearing potential should avoid handling crushed or broken tablets
20
Q

Finasteride and depression

A

stop finasteride immediately and inform HCP

21
Q

Surgery and BPH

A
  • surgery recommended for more severe symptoms
  • do not respond to drugs