Urinary retention Flashcards
(20 cards)
What is urinary retention?
The inability to voluntarily urinate.
What are common causes of urinary retention?
Urethral blockage, BPH, medications (antimuscarinics, sympathomimetics, TCAs), reduced detrusor activity, neurogenic causes, postpartum or postoperative states.
How is acute and chronic urinary retention characterized?
Abrupt inability to pass urine, pain, and a palpable or percussible bladder (medical emergency).
Gradual onset over months/years, incomplete bladder emptying, residual volume >1L, distended or palpable bladder.
What is the first-line treatment for acute urinary retention?
Immediate catheterisation.
What medication is given before catheter removal in acute urinary retention?
An alpha-adrenoceptor blocker (e.g., alfuzosin, tamsulosin) for at least 2 days.
What are long-term options if urinary retention is recurrent or chronic?
Intermittent catheterisation or long-term indwelling catheter if intermittent is not practical.
What are the three types of LUTS?
Voiding symptoms, storage symptoms, and post-micturition symptoms.
Common cause of LUTS in elderly men?
Benign Prostatic Hyperplasia (BPH).
Name two lifestyle changes recommended for LUTS.
Reducing caffeine/alcohol intake and treating constipation.
First-line pharmacological treatment for moderate to severe LUTS?
Alpha-blockers (e.g., tamsulosin, alfuzosin).
What drugs reduce prostate size and risk of progression in BPH?
5-alpha reductase inhibitors (e.g., finasteride, dutasteride).
What drugs help with overactive bladder symptoms?
Antimuscarinics or beta-3 adrenoceptor agonists (e.g., mirabegron).
Which alpha-blocker has the highest risk of floppy iris syndrome?
Tamsulosin.
What are side effects of 5-alpha reductase inhibitors?
Decreased libido, erectile dysfunction, ejaculation disturbance.
Why should antimuscarinics be used cautiously in elderly males?
Risk of falls, confusion, cognitive decline (especially in dementia).
What should be assessed before using antimuscarinics in LUTS?
Post-void residual volume (should be <150 mL).
What symptoms suggest voiding LUTS?
Weak stream, hesitancy, straining, dribbling, incomplete emptying.
What symptoms suggest storage LUTS?
Urgency, frequency, nocturia, urgency incontinence.
How can men reduce post-micturition dribble?
‘Milking’ the urethra after urination.
What drug is used for nocturnal polyuria?
Desmopressin or a late afternoon loop diuretic (e.g., furosemide).
