Bladder & Urinary Disorder

Question 1

What is urinary retention?

Answer 1

The inability to urinate voluntarily

Question 2

What are the causes

Answer 2

• Urethral blockage
• Drug treatments (e.g., antimuscarinics, sympathomimetics, tricyclic antidepressants)
• Conditions affecting bladder muscle contractions or urethra relaxation
• Neurogenic causes
• Postpartum or postoperative conditions

Question 3

What is the common cause of urinary retention in men?

Answer 3

Benign Prostatic Hyperplasia (BPH).

This leads to lower urinary tract symptoms, including urinary
retention, frequency, urgency, and nocturia.

Question 4

What are the different types of Urinary retention?

Answer 4

• Acute Urinary Retention: Sudden inability to urinate, a medical emergency requiring immediate
  catheterisation.
• Chronic Urinary Retention: Gradual inability to empty the bladder fully, characterized by residual urine volume over one liter or a palpable bladder.

Question 5

What is the general treatment for urinary retention?

Answer 5

Catheterisation for acute retention or unknown causes.

Surgery or dilatation for mechanical obstructions.

Question 6

What is the treatment for Acute Urinary Retention?

Answer 6

• Immediate catheterisation.
• Alpha-adrenoceptor blockers (e.g., alfuzosin, doxazosin) administered for at least two days
  before catheter removal.

Question 7

What is the treatment for Chronic Urinary Retention?

Answer 7

• Intermittent bladder catheterisation preferred over indwelling catheters.
• Long-term catheter use if incontinence, infection, or renal dysfunction persist and surgery is not an option.
• Drug treatment with alpha-adrenoceptor blockers for men with moderate-to-severe symptoms after conservative options fail.
• Parasympathomimetic bethanechol chloride is rarely used today.