Urinary retention: Difference between revisions

From Citizendium
Jump to navigation Jump to search
imported>Robert Badgett
mNo edit summary
imported>Robert Badgett
Line 20: Line 20:


==Treatment==
==Treatment==
Retained volumes of more than 900 ml indicated reduced chance of successful removal of the catheter.<ref name="pmid2641206">{{cite journal |author=Taube M, Gajraj H |title=Trial without catheter following acute retention of urine |journal=Br J Urol |volume=63 |issue=2 |pages=180–2 |year=1989 |month=February |pmid=2641206 |doi=10.1111/j.1464-410X.1989.tb05160.x |url= |issn=}}</ref>
Postoperative urinary retention (> 500  ml of urine estimated by bladder scanning) may be better treated with intermittent [[urinary catheterization]] rather than indwelling [[urinary catheterization]].<ref name="pmid15315566">{{cite journal| author=Lau H, Lam B| title=Management of postoperative urinary retention: a randomized trial of in-out versus overnight catheterization. | journal=ANZ J Surg | year= 2004 | volume= 74 | issue= 8 | pages= 658-61 | pmid=15315566  
Postoperative urinary retention (> 500  ml of urine estimated by bladder scanning) may be better treated with intermittent [[urinary catheterization]] rather than indwelling [[urinary catheterization]].<ref name="pmid15315566">{{cite journal| author=Lau H, Lam B| title=Management of postoperative urinary retention: a randomized trial of in-out versus overnight catheterization. | journal=ANZ J Surg | year= 2004 | volume= 74 | issue= 8 | pages= 658-61 | pmid=15315566  
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&email=badgett@uthscdsa.edu&retmode=ref&cmd=prlinks&id=15315566 | doi=10.1111/j.1445-1433.2004.03116.x }} <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref>
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&email=badgett@uthscdsa.edu&retmode=ref&cmd=prlinks&id=15315566 | doi=10.1111/j.1445-1433.2004.03116.x }} <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref>

Revision as of 01:04, 2 December 2009

In medicine, urinary retention is "inability to empty the urinary bladder with voiding (urination).[1] Ten percent of males over the age of 50 may have undiagnosed urinary retention during routine physical examination.[2][3]

In males, antimuscarinic cholinergic antagonists may contribute to retention.[4]

Diagnosis

Urinary retention may be asymptomatic.[2]

Physical examination

Physical examination may detect less than half of cases of postoperative bladder size greater than 400 ml compared to ultrasonography.[5]

Ultrasonography

Bladder ultrasonography may detect urinary retention and reduce unnecessary urinary catheterization[6], but false positives may occur due to cysts of nearby organs.[7]

Treatment

Retained volumes of more than 900 ml indicated reduced chance of successful removal of the catheter.[8]

Postoperative urinary retention (> 500 ml of urine estimated by bladder scanning) may be better treated with intermittent urinary catheterization rather than indwelling urinary catheterization.[9]

The use of bladder ultrasonography may reduce the frequency of intermittent urinary catheterization among patients with spinal cord disorders.[10] Although the use of protocols with bladder scanners to reduce the frequency of urinary catheretization are recommended[11], implementing a critical pathway with a bladder scanner may[5] or may not[12] increase the use of scanning prior to insertion of a urinary catheter.

References

  1. Anonymous (2024), Urinary retention (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. 2.0 2.1 Rosenthal TC, Siepel T, Zubler J, Horwitz M (1994). "The use of ultrasonography to scan the abdomen of patients presenting for routine physical examinations.". J Fam Pract 38 (4): 380-5. PMID 8163963.
  3. Siepel T, Clifford DS, James PA, Cowan TM (2000). "The ultrasound-assisted physical examination in the periodic health evaluation of the elderly.". J Fam Pract 49 (7): 628-32. PMID 10923573. Review in: J Fam Pract. 2001 Feb;50(2):182, 185
  4. Martín-Merino E, García-Rodríguez LA, Massó-González EL, Roehrborn CG (2009). "Do oral antimuscarinic drugs carry an increased risk of acute urinary retention?". J Urol 182 (4): 1442-8. DOI:10.1016/j.juro.2009.06.051. PMID 19683302. Research Blogging.
  5. 5.0 5.1 Warner AJ, Phillips S, Riske K, Haubert MK, Lash N (2000). "Postoperative bladder distention: measurement with bladder ultrasonography.". J Perianesth Nurs 15 (1): 20-5. PMID 10839085.
  6. Sparks A, Boyer D, Gambrel A, Lovett M, Johnson J, Richards T et al. (2004 Jul-Sep). "The clinical benefits of the bladder scanner: a research synthesis.". J Nurs Care Qual 19 (3): 188-92. PMID 15326987.
  7. Alagiakrishnan K, Valpreda M (2009). "Ultrasound bladder scanner presents falsely elevated postvoid residual volumes.". Can Fam Physician 55 (2): 163-4. PMID 19221075. PMC PMC2642496.
  8. Taube M, Gajraj H (February 1989). "Trial without catheter following acute retention of urine". Br J Urol 63 (2): 180–2. DOI:10.1111/j.1464-410X.1989.tb05160.x. PMID 2641206. Research Blogging.
  9. Lau H, Lam B (2004). "Management of postoperative urinary retention: a randomized trial of in-out versus overnight catheterization.". ANZ J Surg 74 (8): 658-61. DOI:10.1111/j.1445-1433.2004.03116.x. PMID 15315566. Research Blogging.
  10. Anton HA, Chambers K, Clifton J, Tasaka J (1998). "Clinical utility of a portable ultrasound device in intermittent catheterization.". Arch Phys Med Rehabil 79 (2): 172-5. PMID 9473999.
  11. Lo E, Nicolle L, Classen D, Arias KM, Podgorny K, Anderson DJ et al. (2008). "Strategies to prevent catheter-associated urinary tract infections in acute care hospitals.". Infect Control Hosp Epidemiol 29 Suppl 1: S41-50. DOI:10.1086/591066. PMID 18840088. Research Blogging. Summary at National Guidelines Clearinghouse
  12. Boyer DR, Steltzer N, Larrabee JH (2009 Jan-Mar). "Implementation of an evidence-based bladder scanner protocol.". J Nurs Care Qual 24 (1): 10-6. DOI:10.1097/NCQ.0b013e31818f52bd. PMID 19092473. Research Blogging.