Urinary retention resident survival guide

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Synonyms and keywords:

Overview

Urinary retention can be defined as an inability to pass urine or incomplete emptying of the bladder. It is one of the most common presenting complaint encountered in the emergency department which can be acute or chronic. It is commonly seen in males as compared to females due to benign prostate hyperplasia. If undiagnosed or left untreated, this condition can be life threatening as it may lead to kidney damage and severe urosepsis. Acute urinary retention can be extremely uncomfortable, brings the patient immediately in attention and is initially managed by urethral or suprapubic catheterization. Chronic urinary retention is often asymptomatic, not easily identified and is linked to increased post void residual volume. A complete detailed history about current prescription, over the counter and herbal medications is necessary along with focused physical examination that must include neurological evaluation.

Causes

Life Threatening Causes

Life-threatening causes include conditions that may result in death or permanent disability within 24 hours if left untreated.

• Life threatening cause 1
• Life threatening cause 2
• Life threatening cause 3

Urinary retention in women

Urinary Retention is overall very rare in women and can be acute or chronic. Common causes include:

• Nerve injury during surgery-For example Episiotomy
• Medications-Atropine, Glycopyrrolate, Bupivacaine
• Obstructive causes-Vaginal hematoma, Vaginal packing, Sling, Foreign body, Pelvic organ prolapse, Urethral injury

Urinary Retention in Men

Urinary retention is much more common in males with male to female ratio being 13:1.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Causes of Acute urinary Retention in Men

❑ Obstructive causes

❑ Benign Prostate Hyperplasia

❑ Prostate or Bladder Carcinoma

❑ Constipation

❑ Urolithiasis

❑ Urethral Stricture

❑ Phimosis or Paraphimosis

❑ Infectious Causes

❑ Prostatitis-

❑ Urethritis-

❑ Genital herpes

❑ Neurological Causes

❑ stroke

❑ spinal cord injury

❑ Demyelinating disorders-Guillain barre syndrome, diabetic neuropathy, Multiple sclerosis.

❑ Detrusor Muscle Dysfunction
❑ Medications

❑ Sympathomimetic alpha adrenergic agents-Phenylephrine

❑ Sympathomimetic beta adrenergic agents-Isoproterenol

❑ Antidepressants-Amitriptyline,Imipramine

❑ Antiarrhythmics-Quinidine, procainamide, Disopyramide

❑ Anticholinergics-Atropine, oxybutynin, glycopyrrolate

❑ Antiparkinsonian agents-Amantadine, trihexyphenidyl,levadopa, bromocriptine

❑ Antipsychotics-Haloperidol, fluphenazine

❑ Hormonal agents-estrogen, progesterone, testosterone

❑ Antihistamines-diphenhydramine, hydroxysine

❑ Antihypertensives-Hydralazine,nifedipine

❑ Others-indomethacin, morphine, dopamine,amphetamines

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Diagnosis

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Treatment

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Do's

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Don'ts

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References

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