Flashcards in Retention Deck (10)
does acute or chronic urinary retention have a higher volume?
chronic >1.5 litres
acute <1 litre
what is a very serious condition to rule out with acute urinary retention and how do you rule it out?
cauda equina syndrome
check anal tone and sacral sensation with a whole spine MRI
what investigations should be done for acute urinary rention?
FBC, U&Es, PSA
what is the management for acute urinary retention?
hourly urine output checks and replace any losses to prevent post obstructive diuresis
trial without catheter
- if failed TWOC or impaired renal function
what are the two classifications of chronic urinary retention??
what causes high pressure chronic urinary retention?
High detrusor pressure @ end of micturition
Typically bladder outflow obstruction
→ bilateral hydronephrosis and ↓ renal function
what causes low pressure chronic urinary retention?
Low detrusor pressure @ end of micturition
Large volume retention c¯ very compliant bladder
Kidney able to excrete urine
No hydronephrosis normal renal function
what is the management of high pressure chronic urinary retention?
same as acute urinary retention
Hrly UO + replace: post-obstruction diuresis
Consider TURP before TWOC
what is the management of low pressure chronic urinary retention?
Avoid catheterisation if possible
Risk of introducing infection
Often do poorly due to poor detrusor function
Need CISC or permanent catheter