Urinary retention: Difference between revisions
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In [[medicine]], '''urinary retention''' is "inability to empty the [[urinary bladder]] with voiding ([[urination]]).<ref>{{MeSH}}</ref> | {{subpages}} | ||
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In [[medicine]], '''urinary retention''' is "inability to empty the [[urinary bladder]] with voiding ([[urination]]).<ref>{{MeSH}}</ref> Ten percent of males over the age of 50 may have undiagnosed urinary retention during routine physical examination.<ref name="pmid8163963">{{cite journal| author=Rosenthal TC, Siepel T, Zubler J, Horwitz M| title=The use of ultrasonography to scan the abdomen of patients presenting for routine physical examinations. | journal=J Fam Pract | year= 1994 | volume= 38 | issue= 4 | pages= 380-5 | pmid=8163963 | |||
| 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=8163963 }} <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref><ref name="pmid10923573">{{cite journal| author=Siepel T, Clifford DS, James PA, Cowan TM| title=The ultrasound-assisted physical examination in the periodic health evaluation of the elderly. | journal=J Fam Pract | year= 2000 | volume= 49 | issue= 7 | pages= 628-32 | pmid=10923573 | |||
| 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=10923573 }} [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=11219571 Review in: J Fam Pract. 2001 Feb;50(2):182, 185] <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref> | |||
In males, antimuscarinic [[cholinergic antagonist]]s may contribute to retention.<ref name="pmid19683302">{{cite journal| author=Martín-Merino E, García-Rodríguez LA, Massó-González EL, Roehrborn CG| title=Do oral antimuscarinic drugs carry an increased risk of acute urinary retention? | journal=J Urol | year= 2009 | volume= 182 | issue= 4 | pages= 1442-8 | pmid=19683302 | In males, antimuscarinic [[cholinergic antagonist]]s may contribute to retention.<ref name="pmid19683302">{{cite journal| author=Martín-Merino E, García-Rodríguez LA, Massó-González EL, Roehrborn CG| title=Do oral antimuscarinic drugs carry an increased risk of acute urinary retention? | journal=J Urol | year= 2009 | volume= 182 | issue= 4 | pages= 1442-8 | pmid=19683302 | ||
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==Diagnosis== | ==Diagnosis== | ||
Urinary retention may be asymptomatic.<ref name="pmid8163963">{{cite journal| author=Rosenthal TC, Siepel T, Zubler J, Horwitz M| title=The use of ultrasonography to scan the abdomen of patients presenting for routine physical examinations. | journal=J Fam Pract | year= 1994 | volume= 38 | issue= 4 | pages= 380-5 | pmid=8163963 | |||
| 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=8163963 }} <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref> | |||
===Physical examination=== | |||
[[Physical examination]] may detect less than half of cases of postoperative bladder size greater than 400 ml compared to [[ultrasonography]].<ref name="pmid10839085">{{cite journal| author=Warner AJ, Phillips S, Riske K, Haubert MK, Lash N| title=Postoperative bladder distention: measurement with bladder ultrasonography. | journal=J Perianesth Nurs | year= 2000 | volume= 15 | issue= 1 | pages= 20-5 | pmid=10839085 | |||
| 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=10839085 }} <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref> | |||
===Ultrasonography=== | ===Ultrasonography=== | ||
Bladder [[ultrasonography]] may detect urinary retention, but false positives may occur due to cysts of nearby organs.<ref name="pmid19221075">{{cite journal| author=Alagiakrishnan K, Valpreda M| title=Ultrasound bladder scanner presents falsely elevated postvoid residual volumes. | journal=Can Fam Physician | year= 2009 | volume= 55 | issue= 2 | pages= 163-4 | pmid=19221075 | Bladder [[ultrasonography]] may detect urinary retention and reduce unnecessary [[urinary catheterization]]<ref name="pmid15326987">{{cite journal| author=Sparks A, Boyer D, Gambrel A, Lovett M, Johnson J, Richards T et al.| title=The clinical benefits of the bladder scanner: a research synthesis. | journal=J Nurs Care Qual | year= 2004 Jul-Sep | volume= 19 | issue= 3 | pages= 188-92 | pmid=15326987 | ||
| 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=15326987 }} <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref>, but false positives may occur due to cysts of nearby organs.<ref name="pmid19221075">{{cite journal| author=Alagiakrishnan K, Valpreda M| title=Ultrasound bladder scanner presents falsely elevated postvoid residual volumes. | journal=Can Fam Physician | year= 2009 | volume= 55 | issue= 2 | pages= 163-4 | pmid=19221075 | |||
| 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=19221075 | pmc=PMC2642496 }} <!--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=19221075 | pmc=PMC2642496 }} <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref> | ||
==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> | |||
The use of bladder [[ultrasonography]] may reduce the frequency of intermittent [[urinary catheterization]] among patients with [[spinal cord]] disorders.<ref name="pmid9473999">{{cite journal| author=Anton HA, Chambers K, Clifton J, Tasaka J| title=Clinical utility of a portable ultrasound device in intermittent catheterization. | journal=Arch Phys Med Rehabil | year= 1998 | volume= 79 | issue= 2 | pages= 172-5 | pmid=9473999 | |||
| 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=9473999 }}</ref> Although the use of protocols with bladder scanners to reduce the frequency of urinary catheretization are recommended<ref name="pmid18840088">{{cite journal| author=Lo E, Nicolle L, Classen D, Arias KM, Podgorny K, Anderson DJ et al.| title=Strategies to prevent catheter-associated urinary tract infections in acute care hospitals. | journal=Infect Control Hosp Epidemiol | year= 2008 | volume= 29 Suppl 1 | issue= | pages= S41-50 | pmid=18840088 | |||
| 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=18840088 | doi=10.1086/591066 }} [http://www.ngc.gov/summary/summary.aspx?ss=15&doc_id=13394 Summary at National Guidelines Clearinghouse]</ref>, implementing a [[critical pathway]] with a bladder scanner may<ref name="pmid10839085"/> or may not<ref name="pmid19092473">{{cite journal| author=Boyer DR, Steltzer N, Larrabee JH| title=Implementation of an evidence-based bladder scanner protocol. | journal=J Nurs Care Qual | year= 2009 Jan-Mar | volume= 24 | issue= 1 | pages= 10-6 | pmid=19092473 | |||
| 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=19092473 | doi=10.1097/NCQ.0b013e31818f52bd }}</ref> increase the use of scanning prior to insertion of a urinary catheter. | |||
===Postoperative urinary retention=== | |||
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 }} | | 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 }}</ref> | ||
"Whilst it may appear that cholinergic agents and intravesically administered prostaglandin offer most promise in the treatment of post-operative urinary retention, the evidence is weak" according to the [[Cochrane Collaboration]]. <ref name="pmid20927768">{{cite journal| author=Buckley BS, Lapitan MC| title=Drugs for treatment of urinary retention after surgery in adults. | journal=Cochrane Database Syst Rev | year= 2010 | volume= 10 | issue= | pages= CD008023 | pmid=20927768 | doi=10.1002/14651858.CD008023.pub2 }} </ref> | |||
| | |||
==References== | ==References== | ||
<references/> | <small> | ||
<references> | |||
</references> | |||
</small> | |||
Latest revision as of 10:08, 16 September 2024
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]
The use of bladder ultrasonography may reduce the frequency of intermittent urinary catheterization among patients with spinal cord disorders.[9] Although the use of protocols with bladder scanners to reduce the frequency of urinary catheretization are recommended[10], implementing a critical pathway with a bladder scanner may[5] or may not[11] increase the use of scanning prior to insertion of a urinary catheter.
Postoperative urinary retention
Postoperative urinary retention (> 500 ml of urine estimated by bladder scanning) may be better treated with intermittent urinary catheterization rather than indwelling urinary catheterization.[12]
"Whilst it may appear that cholinergic agents and intravesically administered prostaglandin offer most promise in the treatment of post-operative urinary retention, the evidence is weak" according to the Cochrane Collaboration. [13]
References
- ↑ Anonymous (2024), Urinary retention (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ 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.
- ↑ 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
- ↑ 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.
- ↑ 5.0 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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
- ↑ 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.
- ↑ 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.
- ↑ Buckley BS, Lapitan MC (2010). "Drugs for treatment of urinary retention after surgery in adults.". Cochrane Database Syst Rev 10: CD008023. DOI:10.1002/14651858.CD008023.pub2. PMID 20927768. Research Blogging.