Urinary retention resident survival guide: Difference between revisions
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A detailed history and a thorough physical examination may help in diagnosing the cause behind urinary retention. | A detailed history and a thorough physical examination may help in diagnosing the cause behind urinary retention. | ||
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{{familytree |boxstyle=background: #FA8072; color: #F8F8FF; | | | | | | | | | | | | | | | | A10 | | | | | A10= <div style="float: left; text-align: left; width: 15em; padding:1em;">'''History''' <br> ❑ [[Inquire about lower urinary symptoms|<span style="color:white;">inquire about lower urinary symptoms</span>]] <br>❑ [[inquire about past history of prostate disease or cancer|<span style="color:white;">Inquire about past history of prostate disease or cancer</span>]] <br>❑ [[Inquire about history of stones, STIs, radiation exposure|<span style="color:white;">Inquire about history of stones, STIs, radiation exposure</span>]] <br> | {{familytree |boxstyle=background: #FA8072; color: #F8F8FF; | | | | | | | | | | | | | | | | A10 | | | | | A10= <div style="float: left; text-align: left; width: 15em; padding:1em;">'''History''' <br> | ||
❑ [[Inquire about lower urinary symptoms|<span style="color:white;">inquire about lower urinary symptoms</span>]] | |||
:❑ [[how often patient has this difficulty in voiding|<span style="color:white;">how often patient has this difficulty in voiding</span>]] | |||
:❑ [[how frequently patient void in a single day|<span style="color:white;">how frequently patient void in a single day</span>]] | |||
:❑ [[how frequently patient has weak stream of urine|<span style="color:white;">how frequently patient has weak stream of urine</span>]] | |||
:❑ [[ask patient about difficulty holding urine|<span style="color:white;">ask patient about difficulty holding urine</span>]] | |||
:❑ [[ask about nocturia|<span style="color:white;">ask about nocturia</span>]] | |||
:❑ [[Does the patient have to strain or push to urinate|<span style="color:white;">Does the patient have to strain or push to urinate</span>]] | |||
:❑ [[ask about dribling after passing urine|<span style="color:white;">ask about dribling after passing urine</span>]]<br> | |||
❑ [[inquire about past history of prostate disease or cancer|<span style="color:white;">Inquire about past history of prostate disease or cancer</span>]] <br> | |||
❑ [[Inquire about history of stones, STIs, radiation exposure|<span style="color:white;">Inquire about history of stones, STIs, radiation exposure</span>]] <br> | |||
❑ [[Other symptoms|<span style="color:white;">Other symptoms</span>]] | ❑ [[Other symptoms|<span style="color:white;">Other symptoms</span>]] | ||
:❑ [[hematuria|<span style="color:white;">hematuria</span>]] | :❑ [[hematuria|<span style="color:white;">hematuria</span>]] |
Revision as of 19:13, 27 August 2020
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.
CAUSES
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 [1]
Urinary Retention in Men
Urinary retention is much more common in males with male to female ratio being 13:1.[2]
❑ 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
A detailed history and a thorough physical examination may help in diagnosing the cause behind urinary retention.
Treatment
Shown below is an algorithm summarizing the treatment of [[disease name]] according the the [...] guidelines.
Do's
- The content in this section is in bullet points.
Don'ts
- The content in this section is in bullet points.
References
- ↑ "StatPearls". 2020. PMID 30860732.
- ↑ Serlin DC, Heidelbaugh JJ, Stoffel JT (2018). "Urinary Retention in Adults: Evaluation and Initial Management". Am Fam Physician. 98 (8): 496–503. PMID 30277739.
- ↑ Lepor H (2005). "Managing and preventing acute urinary retention". Rev Urol. 7 Suppl 8: S26–33. PMC 1477632. PMID 16985887.
- ↑ Roehrborn CG (2005). "Acute urinary retention: risks and management". Rev Urol. 7 Suppl 4: S31–41. PMC 1477606. PMID 16986053.
- ↑ Mevcha A, Drake MJ (2010). "Etiology and management of urinary retention in women". Indian J Urol. 26 (2): 230–5. doi:10.4103/0970-1591.65396. PMC 2938548. PMID 20877602.
- ↑ Hernández Hernández D, Tesouro RB, Castro-Diaz D (2013). "Urinary retention". Urologia. 80 (4): 257–64. doi:10.5301/RU.2013.11688. PMID 24419919.