Urinary retention and bladder obstruction

Question 1

What is urinary retention?

Answer 1

Inability to pass urine

Question 2

What is the normal capacity of the bladder?

Answer 2

400-500mls

Question 3

What are the 4 parts of the male urethra?

Answer 3

• Penile - Housed in corpora spongiosum
• Bulbar
• Membranous - Fossa navicularis (Urine travels clockwise)
• Prostatic - Opening of ejaculatory ducts (Veromantaneum)

Question 4

What are some causes of urinary retention in men?

Answer 4

• BPH
• Prostate cancer
• Bladder cancer
• Bladder stones
• Urethral stricture

Question 5

What are some causes of urinary retention in women?

Answer 5

• Pelvic prolapse
• Pelvic mass - gynae malignancy
• Post-surgery for stress incontinence

Question 6

How will acute urinary retention present?

Answer 6

sudden, painful inability to pass urine, over 1/10 men in their 70s will experiene ARU within the next 5 years and the risk for men in their 80s is nearly 1/3

painful, extreme urge, good renal function

Question 7

How will chronic urinary retention present?

Answer 7

Painless, may not feel any difficulty, renal impairment high due to back pressure on the kidneys

Question 8

What are the 3 main symptoms of bladder issues in urinary retention?

Answer 8

FUN:
F - Frequency
U - Urgency
N - Nocturia

Question 9

What are the 4 main symptoms of outflow obstruction in urinary retention?

Answer 9

SHIP:
S - Straining
H - Hesitancy
I - Intermittency
P - Poor stream

Question 10

What investigation can be performed in urinary retention?

Answer 10

Bladder scan - Can tell the volume of urine in the bladder

Question 11

What is the immediate management option for urinary retention>

Answer 11

Catheterisation

Question 12

How does catheterisation work?

Answer 12

The area is slightly numbed
The catheter is inserted into the urethra up until the Y is reached
Fluid is then pumped into a second tract to inflate a balloon in the bladder to hold it in place