Urinary Retention

Question 1

Presentation of urinary retention

Answer 1

• Upper Urinary Tract Obstruction (i.e. ureters)
  
  • Loin to groin/flank pain on affected side (result of stretching/irritation of ureter and kidney
  • Reduced / no urine output
  • Non-specific symptoms (i.e. vomiting)
  • Reduced renal function on bloods
• Lower Urinary Tract Obstruction (i.e. bladder / urethra)
  
  • Acute urinary retention (unable to pass urine and increasingly full bladder)
  • Lower urinary tract symptoms (i.e. poor flow, difficulty initiating urination, terminal dribbling)
  • Reduced renal function on bloods

Question 2

Causes of urinary retention

Answer 2

• Upper Urinary Tract
  
  • Kidney stones
  • Local cancer masses pressing on the ureters
  • Ureter strictures (scar tissue narrowing tube)
• Lower Urinary Tract
  
  • BPH
  • Prostate cancer
  • Ureter or urethra strictures (from scar tissue)
  • Neurogenic bladder (no neurological signal telling bladder to contract)

Question 3

Complications of urinary retention

Answer 3

• AKI
• Eventually CKD
• Infection (from pooling of urine and retrograde infection – bacteria tracking back up urinary tract)
• Dilated kidney/ureters/bladder
• Pain