Urinary Retention

Question 1

Causes of urinary retention

Answer 1

BPH most commonly
Other urethral obstructions - urethral strictures, calculi, cystocele, constipation or masses.
Medications - anticholingergics, TCAs, opioids, antihistamines, benzos

Question 2

Acute urinary retention presentation

Answer 2

Inability to pass urine
Lower abdominal discomfort
Considerable pain or distress
an acute confusional state may also be present in elderly patients

If background of chronic,
Acute may present with overflow inconttinence

Question 3

Investigations acute urinary retention

Answer 3

BLADDER SCAN
Urine culture and urinalysis as catheterise
Creatinine, U+Es- kidney damage
FBC and CRP

Question 4

Volume of urinary retention

Answer 4

> 300

Question 5

Management acute urinary retention

Answer 5

Catheterisation -> bladder decompression
Measure volume in 15 mins
<200 means not urinary retention

Question 6

What drug start men on when start catheterisation for acute urinary retention

Answer 6

If suspected BPH
Alpha 1 adrenergic antagonist

Question 7

Complications of acute urinary retention

Answer 7

Post obstructive diuretics

Question 8

What is Post obstructive diuresis

Answer 8

Loss of conc gradient -> increase diuresis -> volume depletion -> AKI