Chronic Urinary Retention Flashcards

1
Q

What is chronic urinary retention

A

Painless inability to pass urine

There is long standing retention and significant bladder distension leading to bladder desensititation

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2
Q

Comm on cause in men

A

BPH most common

Urethral strictures or prostate cancer

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3
Q

What can cause it in women?

A

Pelvic prolapse like cystocele, rectocele or uterine prolapse

Pelvic masses can cause chronic retention

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4
Q

Neurological causes

A

Peripheral neuropathies

Parkinsons

MS

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5
Q

Clinical features

A

Painless urinary retention

Associated voiding luts like weak stream and hesitancy

Overflow incontinence might be present

Intra-vesical pressures rise greater than those of the urinary sphincter

Nocturnal enuresis

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6
Q

Examination findings

A

Palpable distended bladder with no or minimal tenderness

Do DRE as well in men

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7
Q

Investigations

A

Post-void bedside bladder scan

Routine bloods with FBC, CRP and U&Es

Highpressure retention warrants US-KUB

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8
Q

Management >1L or evidence of high pressure retention

A

Catheterised with a long-term catheter

Urine output needs bo monitored as well for post-obstructive diuresis

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9
Q

When should TWOC be done?

A

It shouldn’t be done.

Due to risk of repeat renal injury they should have long-term catheter before definitve management

Alternatives to this include ISC or suprapubic catherisation

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10
Q

Definitive management of chronic retention

A

Depends on underlying cause

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11
Q

Long term management without long-term catheter

A

Intermittent self catheterisation

Patients are taught how to do it themselves at regular intervals every 4-6hrs

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12
Q

Complications

A

UTI

Bladder calculi

CKD

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