Urinary retention Flashcards
1
Q
Define retention
A
Retention mean not emptying the bladder due to obstruction or reduced detrusor power.
2
Q
What are the causes of acute urinary retention?
A
Prostatic obstruction Urethral strictures Anti-cholinergics 'holding' Alcohol Constipation Post-op (pain, inflammation, anaesthetics) Infection Neurological e.g. cauda equina syndrome Carcinoma
3
Q
How is acute retention investigated?
A
Abdomen
DRE of prostate
Peri-anal sensation
MSU
U&E
FBC
PSA
4
Q
How is voiding encouraged?
A
Analgesia Privacy on hospital wards Catheterisation Alpha blocker 3-way catheter to reduced clots and washout bladder
5
Q
How does chronic retention present?
A
Chronic retention is more insidious and may be painless. The bladder capacity can increase from 600ml of >1.5L.
Overflow incontinence, acute or chronic retention, lower abdominal mass, UTI, or renal failure.
6
Q
What causes chronic retention?
A
Prostatic enlargement Pelvic malignancy Rectal surgery Diabetes mellitus CNS disease (e.g. MS)
