Urinary Retention
March 2018 | by EMauthor
Acute urinary retention is more common in men. In most cases, the diagnosis is obvious: the patient complains of inability to pass urine combined with lower abdominal discomfort. There is often a history of prior episodes or of increasing difficulty with urination. Search for evidence of prolapsed disc or cord compression by checking the lower limb strength and reflexes and perineal sensation. Perform a rectal examination to assess anal tone and the size and consistency of the prostate gland. In many cases a complete physical exam will need to be deferred until the bladder has been drained, since the patient will be in too much discomfort The patient requires urgent bladder decompression. Provided there is no contraindication (such as urinary retention following trauma or as a result of urethral stenosis), this is achieved by urethral catheterization. Absolute referral criteria for admission post catheter (via surgical SHO) •UOP including residual > 1 litre at 2 hours (consider clamping) •Residual > 650 mL •UOP > 200 mL hour •Significant infection •Acute kidney injury •Significant haematuria |
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