Acute urinary retention
Revisión del 23:48 6 ago 2011 de Fsanchezmd (discusión | contribs.) (Created page with "== Background == *Urinary retention is the inability to void resulting in bladder distention *Symptoms include frequency, urgency, hesitancy, dribbling, decrease in voiding stre...")
Background
- Urinary retention is the inability to void resulting in bladder distention
- Symptoms include frequency, urgency, hesitancy, dribbling, decrease in voiding stream
- A sense of incomplete emptying
- Most commonly affects adult men 2/2 BPH, however must exclude neurologic disease (ie Cord compression)
- Common causes: BPH, prostatic carcinoma, bladder carcinoma, urethral stricture, spinal cord disease or trauma, and blood clots
- Uncomon causes: phimosis, paraphimosis, urethritis, urethral calculus, foreign body, medications(primarily anticholinergics but also narcotics, phenothiazines, sympathomimetics, cyclic antidepressants, antihistamines, antihypertensives, and muscle relaxants)
Work-Up
- UA, UCX, CBC, Chem Panel
- Complete GU/Rectal exam
Treatment
- Bladder Decompression
- Pass 16F Foley catheter(larger if large blood clots)
- If unable to pass Foley catheter, try a 16F Coude catheter
- If still unable, try a smaller size, obtain urologic consult, or perform suprapubic catherization
Disposition
- Consider admission to Urology if uncontrolled pain, obstruction with infection, or inability to clear large clots
- Pt with obstructive uropathy, go home with catheter and leg drainage bag
- Follow up with Urology within 1 week