Chronic Urinary Retention Flashcards Preview

Y3M - Urology > Chronic Urinary Retention > Flashcards

Flashcards in Chronic Urinary Retention Deck (12)
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1

What is chronic urinary retention

Painless inability to pass urine

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

2

Comm on cause in men

BPH most common

Urethral strictures or prostate cancer

3

What can cause it in women?

Pelvic prolapse like cystocele, rectocele or uterine prolapse

Pelvic masses can cause chronic retention

4

Neurological causes

Peripheral neuropathies

Parkinsons

MS

5

Clinical features

 

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

6

Examination findings

Palpable distended bladder with no or minimal tenderness

Do DRE as well in men

7

Investigations

Post-void bedside bladder scan

Routine bloods with FBC, CRP and U&Es

Highpressure retention warrants US-KUB

8

Management  >1L or evidence of high pressure retention

Catheterised with a long-term catheter

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

9

When should TWOC be done?

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

10

Definitive management of chronic retention

Depends on underlying cause

11

Long term management without long-term catheter

Intermittent self catheterisation

 

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

12

Complications

UTI

Bladder calculi

CKD