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Urinary Retention (Acute
(painful) (Functional (Neuro deficit (Peripheral…
Urinary Retention
Acute
(painful)
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Functional
Drugs (flu medicine, anticholinergics)
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Acute mx
symptomatic, RU >300ml, NPU >6h
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RU < 300ml
ambulating, BO, double voiding, pot, warm bladder compress, K citrate (10ml TDS, wait 1h)
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Lower urinary tract sx:
(irritative) FUN - frequency, urgency, nocturia
(obstructive) DISSHE - terminal dribbling, intermittent, poor stream, strain, hesitancy, incomplete empytingComplication:
- urinary stones (Hydronephrosis (obstructive nephropathy)
- UTI
- renal failure - AMS, N/V
Inx:
- DRE for impacted stools, prostate size & consistency, anal tone
- inguinal lymph nodes
- bloods: FBC, inflammatory markers, renal panel, urine dipstick/UFEME/urine culture, blood culture (if septic), PSA
- radio: U/S KUB (hydronephrosis), CT KUB, CT TAP + bone scan (prostate cancer workup)
- special: cystoscopy (for strictures)
mx:
- double void/pot/warm compress/K citrate/IDC (diagnostic & therapeutic)
- analgesia
- refer to uro for fill-and-pull/med onco/geriatrics
- BPH - watchful waiting, alpha blocker/5a reductase inhibitors, TURP
- neurogenic bladder - suprapubic pressure/double void, Ach agonist, intermittent IDC/sacral nerve stimulation