Assessment and Management of Acute Urinary Retention

Author: Andrew Parfitt, Peter Jaye / Editor: Andrew Parfitt, Peter Jaye / Reviewer: Jason Kendall, Amanda King / Codes: / Published: 13/07/2022

This session covers the common presentations of urinary retention and its management in the emergency department. It also covers the common problems that can occur in patients who have in-dwelling catheters.

Learning objectives

  • Diagnose urinary retention
  • Explain why a full clinical and rectal examination should always be conducted
  • Describe investigations that are necessary in a patient with retention and how to evaluate them
  • Identify the complications of urethral catheterisation and be able to respond to them whilst awaiting specialist urological input
  • Summarise the evidence base relevant to the further management of a patient in acute urinary retention

References

  1. Cathcart P, van der Meulen J, et al. Incidence of primary and recurrent acute urinary retention between 1998 and 2003 in England. J Urol. 2006 Jul;176(1):200-4; discussion 204.
  2. Pickard R, Emberton M, Neal DE. The management of men with acute urinary retention. National Prostatectomy Audit Steering Group. Br J Urol. 1998 May;81(5):712-20.
  3. Choong S, Emberton M. Acute urinary retention. BJU Int. 2000 Jan;85(2):186-201. doi: 10.1046/j.1464-410x.2000.00409.x.
  4. Manikandan R, Srirangam SJ, O’Reilly PH, Collins GN. Management of acute urinary retention secondary to benign prostatic hyperplasia in the UK: a national survey. BJU Int. 2004 Jan;93(1):84-8.
  5. Kumar P, Pati J. Suprapubic catheters: indications and complications. Br J Hosp Med (Lond). 2005 Aug;66(8):466-8.
  6. Taube M, Gajraj H. Trial without catheter following acute retention of urine. Br J Urol. 1989 Feb;63(2):180-2.
  7. Desgrandchamps F, De La Taille A, Doublet JD; RetenFrance Study Group. The management of acute urinary retention in France: a cross-sectional survey in 2618 men with benign prostatic hyperplasia. BJU Int. 2006 Apr;97(4):727-33.
  8. Moisey CU, Williams LA. Self-retained balloon catheters – a safe method for removal. Br J Urol. 1980 Feb;52(1):67. doi: 10.1111/j.1464-410x.1980.tb02926.x.
  9. McNeill SA, Hargreave TB, Roehrborn CG; Alfaur study group. Alfuzosin 10 mg once daily in the management of acute urinary retention: results of a double-blind placebo-controlled study. Urology. 2005 Jan;65(1):83-9; discussion 89-90.
  10. Edwards JE, Moore RA. Finasteride in the treatment of clinical benign prostatic hyperplasia: a systematic review of randomised trials. BMC Urol. 2002;2:14. doi:10.1186/1471-2490-2-14.
  11. Horgan AF, Prasad B, Waldron DJ, O’Sullivan DC. Acute urinary retention. Comparison of suprapubic and urethral catheterisation. Br J Urol. 1992 Aug;70(2):149-51. doi: 10.1111/j.1464-410x.1992.tb15693.x. PMID: 1393437.
  12. Hassouna M, Elmayergi N, Abdelhady M. Acute Urinary Retention in the elderly. US Kidney and Urological Disease. June 2005; 1-3 Touch Briefing.
  13. Garnham F, Smith C. Prophylactic antibiotics in urinary catheterisation to prevent infection. Emergency Medicine Journal 2006;23: 649.
  14. Nil-Weise BS, van den Broek PJ. Antibiotic policies for short-term catheter bladder drainage in adults. Cochrane Database Syst Rev. 2005 Jul 20;(3):CD005428.
  15. Djavan B, Marberger M. A meta-analysis on the efficacy and tolerability of alpha1-adrenoceptor antagonists in patients with lower urinary tract symptoms suggestive of benign prostatic obstruction. Eur Urol. 1999;36(1):1-13.
  16. Selius BA, Subedi R. Urinary retention in adults: diagnosis and initial management. Am Fam Physician. 2008 Mar 1;77(5):643-50. PMID: 18350762.
  17. Brosnahan J, Jull A, Tracy C. Types of urethral catheters for management of short-term voiding problems in hospitalised adults. Cochrane Database Syst Rev. 2004;(1):CD004013. Update in: Cochrane Database Syst Rev. 2008;(2):CD004013. PMID: 14974052.
  18. McNeill SA, Hargreave TB. Efficacy of PSA in the detection of carcinoma of the prostate in patients presenting with acute urinary retention. J R Coll Surg Edinb. 2000 Aug;45(4):227-30.

Leave a Reply