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Urinary retention

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700: 714:(urination) abnormality. Common findings, determined by ultrasound of the bladder, include a slow rate of flow, intermittent flow, and a large amount of urine retained in the bladder after urination. A normal test result should be 20-25 mL/s peak flow rate. A post-void residual urine greater than 50 ml is a significant amount of urine and increases the potential for recurring urinary tract infections. In adults older than 60 years, 50-100 ml of residual urine may remain after each voiding because of the decreased contractility of the 692: 40: 309: 893:(TURP) may be performed to relieve bladder obstruction. Surgical complications from TURP include a bladder infection, bleeding from the prostate, scar formation, inability to hold urine, and inability to have an erection. The majority of these complications are short lived, and most individuals recover fully within 6–12 months. 981:
Urinary retention in females is uncommon, occurring 1 in 100,000 every year, with a female-to-male incidence rate of 1:13. It is usually transient. The causes of UR in women can be multi-factorial, and can be postoperative and postpartum. Prompt urethral catheterization usually resolves the problem.
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Urinary retention is a common disorder in elderly males. The most common cause of urinary retention is BPH. This disorder starts around age 50 and symptoms may appear after 10–15 years. BPH is a progressive disorder and narrows the neck of the bladder leading to urinary retention. By the age of 70,
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technique in one simple demonstration, and that reduces the rate of infection from long-term Foley catheters. Self catheterization requires doing the procedure periodically during the day, the frequency depending on fluid intake and bladder capacity. If fluid intake/outflow is around 1.5 litres per
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Non-neurogenic chronic urinary retention does not have a standardized definition; however, urine volumes >300mL can be used as an informal indicator. Diagnosis of urinary retention is conducted over a period of 6 months, with 2 separate measurements of urine volume 6 months apart. Measurements
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Chronic urinary retention that is due to bladder blockage which can either be as a result of muscle damage or neurological damage. If the retention is due to neurological damage, there is a disconnect between the brain to muscle communication, which can make it impossible to completely empty the
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and an inability to pass urine. The exact number of individuals with acute prostatitis is unknown, because many do not seek treatment. In the US, at least 1–3 percent of males under the age of 40 develop urinary difficulty as a result of acute prostatitis. Most physicians and other health care
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showed that in the sitting position, the residual urine in the bladder was significantly reduced, the maximum urinary flow was increased, and the voiding time was decreased. For healthy males, no influence was found on these parameters, meaning that they can urinate in either position.
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Intermittent catheterization can be done by a health care professional or by the person themselves (clean intermittent self catheterization). Intermittent catheterization performed at the hospital is a sterile technique. Patients can be taught to use a
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professionals are aware of these disorders. Worldwide, both BPH and acute prostatitis have been found in males of all races and ethnic backgrounds. Cancers of the urinary tract can cause urinary obstruction but the process is more gradual.
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almost 10 percent of males have some degree of BPH and 33% have it by the eighth decade of life. While BPH rarely causes sudden urinary retention, the condition can become acute in the presence of certain medications including
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Use of alpha-blockers can provide relief of urinary retention following de-catheterization for both men and women. In case, if catheter can't be negotiated, suprapubic puncture can be done with lumbar puncture needle.
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involved with bladder function and it can lead to an increased risk of postoperative urinary retention. The risk of postoperative urinary retention increases up to 2.11 fold for people older than 60 years.
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Older people with ongoing problems may require continued intermittent self catheterization (CISC). CISC has a lower infection risk compared to catheterization techniques that stay within the body.
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day, this would typically be performed roughly three times per day, i.e. roughly every six to eight hours during the day, more frequently when fluid intake is higher and/or bladder capacity lower.
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For acute urinary retention, treatment requires urgent placement of a urinary catheter. A permanent urinary catheter may cause discomfort and pain that can last several days.
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Onset can be sudden or gradual. When the onset is sudden, symptoms include an inability to urinate and lower abdominal pain. When of gradual onset, symptoms may include
178:. Onset can be sudden or gradual. When of sudden onset, symptoms include an inability to urinate and lower abdominal pain. When of gradual onset, symptoms may include 1091:"Monitoring of micturition and bladder volumes can replace routine indwelling urinary catheters in children receiving intravenous opioids: a prospective cohort study" 284:, or surgery. Males are more often affected than females. In males over the age of 40 about 6 per 1,000 are affected a year. Among males over 80 this increases 30%. 1064: 1138:
Sliwinski A, D'Arcy FT, Sultana R, Lawrentschuk N (April 2016). "Acute urinary retention and the difficult catheterization: current emergency management".
344:. Other patients may develop a shock-like condition and may require admission to a hospital. Serious complications of untreated urinary retention include 1589: 756:), parasthesias, decreased anal sphincter tone, or altered deep tendon reflexes, an MRI of the lumbar spine should be considered to further assess 607:
bladder. If the retention is due to muscle damage, it is likely that the muscles are not able to contract enough to completely empty the bladder.
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to decrease prostate enlargement. The drugs only work for mild cases of BPH but also have mild side effects. Some of the medications decrease
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showing a trabeculated wall, seen as small irregularities mainly at left (superior part). This is strongly associated with urinary retention.
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Acute urinary retention is treated by placement of a urinary catheter (small thin flexible tube) into the bladder. This can be either an
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Stones or metastases, which can theoretically appear anywhere along the urinary tract, but vary in frequency depending on anatomy.
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and requires prompt treatment. The pain can be excruciating when urine is not able to flow out. Moreover, one can develop severe
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tone and predispose people to bladder overdistention and subsequent retention. Spinal anesthesia results in a blockade of the
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Surgery related: Operative times longer than 2 hours may lead to an increased risk of postoperative urinary retention 3-fold.
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Obstruction in the urethra, for example a stricture (usually caused either by injury or STD), a metastasis or a precipitated
352:. Urinary retention is a disorder treated in a hospital, and the quicker one seeks treatment, the fewer the complications. 254: 1702:"Presentation and prognosis of female acute urinary retention: Analysis of an unusual clinical condition in outpatients" 521:
causes numerous strictures, leading to a "rosary bead" appearance, whereas chlamydia usually causes a single stricture)
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In acute cases of urinary retention where associated symptoms in the lumbar spine are present such as pain, numbness (
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Challenges with CISC include compliance issues as some people may not be able to place the catheter themselves.
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biopsy of the prostate (transrectal ultrasound guided) can distinguish between these prostate conditions. Serum
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by acting as a smooth muscle relaxant. General anesthetics can directly interfere with autonomic regulation of
416: 1181: 644: 619: 432: 411: 2021: 910: 679: 588: 462: 194: 585:. Spinal anesthesia shows a higher risk of postoperative urinary retention compared to general anesthesia. 441:(caused by medical treatment/procedure) scarring of the bladder neck (commonly from removal of indwelling 1597: 886: 785: 489: 151: 1575: 1393:"The role of alpha blockers prior to removal of urethral catheter for acute urinary retention in men" 726: 242: 1852: 1800: 625: 555: 296:, mild lower abdominal pain, and a weak urine stream. Those with long-term problems are at risk of 182:, mild lower abdominal pain, and a weak urine stream. Those with long-term problems are at risk of 769: 703: 567: 563: 424: 297: 269: 183: 122: 86: 1321:
Stoffel JT (September 2017). "Non-neurogenic Chronic Urinary Retention: What Are We Treating?".
265:. Diagnosis is typically based on measuring the amount of urine in the bladder after urinating. 2043: 780:
relieves the retention. In the longer term, treatment depends on the cause. BPH may respond to
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In young males, the most common cause of urinary retention is infection of the prostate (
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de Jong Y, Pinckaers JH, ten Brinck RM, Lycklama à Nijeholt AA, Dekkers OM (2014).
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Blockage of the urethra, nerve problems, certain medications, weak bladder muscles
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procedure. While both procedures are relatively safe, complications can occur.
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that is placed with a small inflatable bulb that holds the catheter in place.
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Kowalik U, Plante MK (June 2016). "Urinary Retention in Surgical Patients".
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may be needed to explore the urinary passage and rule out blockages.
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determinations may be necessary to rule out backflow kidney damage.
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de Jong AC, Maaskant JM, Groen LA, van Woensel JB (January 2021).
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Some people with BPH are treated with medications. These include
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Anesthesia: General anesthetics during surgery may cause bladder
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National Institute of Diabetes and Digestive and Kidney Diseases
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can gradually obstruct urine output. Cancers often present with
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causes – psychosocial stresses, fear associated with urination,
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In the longer term, obstruction of the urinary tract may cause:
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National Kidney and Urologic Diseases Information Clearinghouse
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should have a PVR (post-void residual) volume of >300mL.
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Analysis of urine flow may aid in establishing the type of
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The most common cause of chronic urinary retention is BPH.
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Urinary retention with greatly enlarged bladder as seen by
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The urinary bag of a person with post obstructive diuresis
1207:, Swamy S, Gill K, Kupelian A, Malone-Lee J (July 2018). 1440:"Etiology and management of urinary retention in women" 978:, lower back pain or gradual distension in the flanks. 1390: 1752: 1566:
Ellsworth PI (10 February 2010). Stöppler MC (ed.).
878:form of urinary retention may require some type of 1514: 1370:. Lippincott Williams & Wilkins. p. 306. 812:to relax smooth muscles in the bladder neck, and 554:and medications with anticholinergic properties, 2094: 1363: 85:: Frequent urination, loss of bladder control, 1391:Fisher E, Subramonian K, Omar MI (June 2014). 233:. Medications that can cause problems include 165:6 per 1,000 per year (males > 40 years old) 33:Ischuria, bladder failure, bladder obstruction 1868: 1699: 1274: 562:, nonsteroidal anti-inflammatories (NSAIDs), 114:Amount of urine in the bladder post urination 1437: 1397:The Cochrane Database of Systematic Reviews 896: 1875: 1861: 1316: 1314: 1312: 1310: 1308: 1306: 1182:"General information on urinary retention" 1049: 1047: 1045: 1043: 1041: 1039: 1037: 1035: 1033: 1031: 1029: 1027: 1025: 1023: 1021: 1019: 1017: 1015: 80:: Inability to urinate, low abdominal pain 38: 1727: 1717: 1654: 1644: 1565: 1542: 1532: 1494:"Clean Intermittent Self-Catheterization" 1465: 1455: 1414: 1404: 1232: 1114: 1013: 1011: 1009: 1007: 1005: 1003: 1001: 999: 997: 995: 16:Inability to completely empty the bladder 905:on the influence of voiding position on 698: 690: 307: 174:is an inability to completely empty the 1515:Seth JH, Haslam C, Panicker JN (2014). 1320: 1303: 891:transurethral resection of the prostate 794:transurethral resection of the prostate 2095: 1364:Graham SE, Keane TE, Glenn JF (2010). 1140:European Journal of Emergency Medicine 1084: 1082: 992: 1856: 1487: 1485: 1277:The Surgical Clinics of North America 287: 1270: 1268: 1266: 1264: 1262: 1260: 1258: 1256: 1254: 1252: 255:nonsteroidal anti-inflammatory drugs 1491: 1213:International Urogynecology Journal 1079: 1067:from the original on 4 October 2017 371:(atonic bladder is an extreme form) 13: 2103:Symptoms and signs: Urinary system 1685:. 10 February 2010. Archived from 1482: 14: 2119: 1748: 1438:Mevcha A, Drake MJ (April 2010). 1249: 483: 1521:Patient Preference and Adherence 530: 303: 217:. Nerve problems can occur from 1912:Costovertebral angle tenderness 1693: 1671: 1612: 1582: 1559: 1508: 1431: 917: 189:Causes include blockage of the 1406:10.1002/14651858.CD006744.pub3 1384: 1357: 1196: 1174: 1131: 1095:European Journal of Pediatrics 412:Detrusor sphincter dyssynergia 272:either through the urethra or 268:Treatment is typically with a 1: 985: 803: 654:Use of NSAIDs, or drugs with 620:Tethered spinal cord syndrome 433:meningitis-retention syndrome 324:Acute urinary retention is a 2022:Lower urinary tract symptoms 1700:Özveren B, Keskin S (2016). 1646:10.1371/journal.pone.0101320 1590:"Urinary retention overview" 1152:10.1097/MEJ.0000000000000334 911:lower urinary tract symptoms 889:(BPH), a procedure known as 788:therapy, or surgically with 768:In acute urinary retention, 763: 686: 680:artificial urinary sphincter 589:Benign prostatic hyperplasia 463:Benign prostatic hyperplasia 195:benign prostatic hyperplasia 7: 887:benign prostate hyperplasia 835: 786:5-alpha-reductase inhibitor 539:Age: Older people may have 456: 377:(congestion of the kidneys) 10: 2124: 1107:10.1007/s00431-020-03703-7 869: 601: 490:Congenital urethral valves 402: 2057: 2014: 1988: 1925: 1894: 1826: 1756: 1444:Indian Journal of Urology 1335:10.1007/s11934-017-0719-2 1289:10.1016/j.suc.2016.02.004 1225:10.1007/s00192-017-3472-7 727:prostate-specific antigen 556:alpha-adrenergic agonists 397: 243:tricyclic antidepressants 161: 137: 118: 108: 100: 92: 71: 55: 46: 37: 29: 24: 1719:10.4103/0974-7796.192111 1367:Glenn's Urologic Surgery 1203:Khasriya R, Barcella W, 897:Sitting voiding position 613: 570:, may increase the risk. 568:beta-adrenergic agonists 564:calcium-channel blockers 298:urinary tract infections 184:urinary tract infections 1457:10.4103/0970-1591.65396 1323:Current Urology Reports 935:medications, and after 770:urinary catheterization 637:psychoactive substances 425:multiple system atrophy 294:loss of bladder control 180:loss of bladder control 152:5α-reductase inhibitors 87:urinary tract infection 2044:Extravasation of urine 1683:Urology Channel Portal 1679:"Urologic Emergencies" 1568:"Inability to urinate" 885:In most patients with 725:Determining the serum 707: 696: 665:Muscarinic antagonists 421:demyelinating diseases 321: 960:Cancer of the bladder 842:intermittent catheter 778:suprapubic cystostomy 758:cauda equina syndrome 702: 694: 535:Risk factors include 452:Damage to the bladder 319: 231:heavy metal poisoning 1933:Urinary incontinence 1192:on 20 February 2010. 854:self catheterization 635:Consumption of some 509:crystal in the urine 223:spinal cord problems 1958:Post-void dribbling 1637:2014PLoSO...9j1320D 1504:on 6 February 2016. 1055:"Urinary Retention" 695:As seen on axial CT 597:Postoperative pain. 348:damage and chronic 342:high blood pressure 199:urethral strictures 1953:Nocturnal enuresis 1884:Signs and symptoms 1827:External resources 1600:on 29 January 2010 1534:10.2147/PPA.S49060 1498:The New York Times 972:blood in the urine 937:spinal anaesthesia 708: 697: 583:micturition reflex 417:Neurogenic bladder 322: 288:Signs and symptoms 62:Emergency medicine 2090: 2089: 1980:Urinary retention 1850: 1849: 1841:Urinary retention 1689:on 10 March 2010. 1186:Retention Urinary 925:antihypertensives 772:, placement of a 754:saddle anesthesia 513:Pseudodyssynergia 497:or pinhole meatus 471:and other pelvic 326:medical emergency 317: 278:urethral dilation 172:Urinary retention 169: 168: 127:urethral dilation 110:Diagnostic method 25:Urinary retention 19:Medical condition 2115: 1943:Diurnal enuresis 1917:Vesical tenesmus 1886:relating to the 1877: 1870: 1863: 1854: 1853: 1754: 1753: 1742: 1741: 1731: 1721: 1697: 1691: 1690: 1675: 1669: 1668: 1658: 1648: 1616: 1610: 1609: 1607: 1605: 1596:. Archived from 1586: 1580: 1579: 1578:on 5 March 2010. 1574:. Archived from 1572:eMedicine Health 1563: 1557: 1556: 1546: 1536: 1512: 1506: 1505: 1500:. Archived from 1489: 1480: 1479: 1469: 1459: 1435: 1429: 1428: 1418: 1408: 1388: 1382: 1381: 1361: 1355: 1354: 1318: 1301: 1300: 1272: 1247: 1246: 1236: 1219:(7): 1019–1028. 1200: 1194: 1193: 1188:. Archived from 1178: 1172: 1171: 1135: 1129: 1128: 1118: 1086: 1077: 1076: 1074: 1072: 1051: 552:Anticholinergics 318: 235:anticholinergics 42: 22: 21: 2123: 2122: 2118: 2117: 2116: 2114: 2113: 2112: 2093: 2092: 2091: 2086: 2072:Brewer infarcts 2053: 2010: 1984: 1921: 1890: 1881: 1851: 1846: 1845: 1822: 1821: 1765: 1751: 1746: 1745: 1698: 1694: 1677: 1676: 1672: 1617: 1613: 1603: 1601: 1588: 1587: 1583: 1564: 1560: 1513: 1509: 1490: 1483: 1436: 1432: 1399:(6): CD006744. 1389: 1385: 1378: 1362: 1358: 1319: 1304: 1273: 1250: 1201: 1197: 1180: 1179: 1175: 1136: 1132: 1087: 1080: 1070: 1068: 1063:. 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Index


CT scan
Specialty
Emergency medicine
urology
Symptoms
urinary tract infection
Diagnostic method
Catheter
urethral dilation
urethral stents
Medication
Alpha blockers
terazosin
5α-reductase inhibitors
finasteride
bladder
loss of bladder control
urinary tract infections
urethra
benign prostatic hyperplasia
urethral strictures
bladder stones
cystocele
constipation
tumors
diabetes
spinal cord problems
stroke
heavy metal poisoning

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