Acute Urinary Retention

• Precipitants

  • overfilling of bladder

  • faecal loading

  • urinary tract infection

  • post-operatively

Diagnosis

• acute distress

• abdominal / perineal pain

• easily palpable bladder

Management

• History of

  • similar episodes - difficulties in catheterisation

  • surgery - prostatectomy, urethral stricture

  • accidental injury

• Catheterisation

  • urethral

  • suprapubic

• Cyostoscopy with prostatectomy / bladder neck resection if

  • huge volume released (chronic obstruction)

  • raised levels serum urea and creatinine (chronic obstructive uropathy)

  • previous episode of acute retention

  • bladder outflow obstruction caused by carcinoma of prostate

  • failure of 'trial without catheter'

  • acute retention plus history of prostatism

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