Urinary Retention

Question 1

cause?

Answer 1

obstruction or ↓detrusor activity
low detrusor activity: This can result from neurological conditions such as MS, autonomic neuropathy, GBM, DM spina bifida or spinal cord disease

Question 2

Presentation?

• Acute Retention
• Chronic Retention

Answer 2

Acute Retention
Painful
Sudden onset
Normal bladder capacity (400-500ml)

Chronic Retention
Painless
Insidious, gradual onset
Bladder capacity may be huge (up to 10 litres)

Question 3

acute or chronic retention - which one results in renal failure and is life threatening?

Answer 3

chronic

Question 4

Mx

Answer 4

Voiding tricks – Running water, analgesia, privacy
Catheterise!
Tamsulosin

The patient will need to be catheterised. In patients with chronic retention, they may need to be educated on how to perform catheterisation long term

Tamsulosin – Although this is thought of as just a BPH drug there are alpha receptors in the bladder neck as well as the prostate and so patients in retention will also be given this prior to the removal of the catheter