Acute Urinary Retention Flashcards
(43 cards)
What is acute urinary retention investigations?
Bladder scan or ultrasound of renal tract
Urinarlysis
Evaluation of post-void residual
What are causes of urinary retention?
Post-surgery
Constipation
Stone
Blood clot
Tumour
UTI
Cauda equine
Anticholinergic medication
What is the inital imaging for acute urinary retention/
Bladder scan or ultrasound of renal tract
Catheter
Evaluation of post-void rsidal
Which medication commonly causes urinary retention in older patients?
Amitriptyline with its anti-cholinergic effects
What is the presentation of urinary retention?
Inability to pass urine
Lower abdominal discomfort
Pain or distress
Suprapubic tenderness
Suprapubic mass (due to an enlarged bladder)
Delirium (hypoactive or hyperactive
Wat are the investigations for urinary retention?
Ultrasound
Cystoscope
Urinalysis
FBC and renal profile
What is the management of urinary retention?
Catheterisation
What is a side effect of tamsulosin?
Postural hypotension in elderly
What is the most common cause of acute urinary retention in older males?
BPH
-> suprapubic tenderness and inability to pass urine
How do bladder alculi present?
Lower abdominal pain
Urinary symptoms
Unlikely to cause acute urary renteiont
Which anti-emetic causes acute urinary retention?
Cyclizine, a H1 receptor antagonist which has some anticholinergic effect. Should be used with caution in elderly due to risk of delirium or urinary/bowell retention.
What does difficulty passing urine and neurological symptom indicate?
Multiple sclerosis so it is important to do MRI head and spine
What is acute urinary retention?
Inability to voluntarily pass urine suddenly over a period of hours or less
It is the most common urological emergency.
In which gender is acute urinary retention more common?
Men
Incidence ratio of 13:1 between men and women.
At what age does the incidence of acute urinary retention increase significantly in men?
Over 60 years of age
What percentage of men in their 80s is estimated to develop acute urinary retention over five years?
Around a third
What is the most common cause of acute urinary retention in men?
Benign prostatic hyperplasia
What are some other potential causes of urethral obstruction leading to acute urinary retention?
- Urethral strictures
- Calculi
- Cystocele
- Constipation
- Masses
Which types of medications can cause acute urinary retention?
- Anticholinergics
- Tricyclic antidepressants
- Antihistamines
- Opioids
- Benzodiazepines
What can trigger acute urinary retention in patients with predisposing factors?
A simple urinary tract infection
In which scenarios is acute urinary retention often observed?
- Postoperatively
- In women postpartum
What are typical presentations of patients with acute urinary retention?
- Inability to pass urine
- Lower abdominal discomfort
- Considerable pain or distress
- Acute confusional state in elderly patients
How does acute urinary retention differ from chronic urinary retention?
Acute urinary retention is typically painful, while chronic urinary retention is painless
What signs might indicate acute urinary retention upon examination?
- Palpable distended urinary bladder
- Lower abdominal tenderness
