Urinary Retention in Adults: Evaluation and Initial Management
By A Mystery Man Writer
Description
Urinary retention is the acute or chronic inability to voluntarily pass an adequate amount of urine. The condition predominantly affects men. The most common causes are obstructive in nature, with benign prostatic hyperplasia accounting for 53% of cases. Infectious, inflammatory, iatrogenic, and neurologic causes can also affect urinary retention. Initial evaluation should involve a detailed history that includes information about current prescription medications and use of over-the-counter medications and herbal supplements. A focused physical examination with neurologic evaluation should be performed, and diagnostic testing should include measurement of postvoid residual (PVR) volume of urine. There is no consensus regarding a PVR-based definition for acute urinary retention; the American Urological Association recommends that chronic urinary retention be defined as PVR volume greater than 300 mL measured on two separate occasions and persisting for at least six months. Initial management of urinary retention involves assessment of urethral patency with prompt and complete bladder decompression by catheterization. Suprapubic catheters improve patient comfort and decrease bacteriuria and the need for recatheterization in the short term; silver alloy–coated and antibiotic-impregnated catheters offer clinically insignificant or no benefit. Further management is decided by determining the cause and chronicity of the urinary retention and can include initiation of alpha blockers with voiding trials. Patients with urinary retention related to an underlying neurologic cause should be monitored in conjunction with neurology and urology subspecialists.
![Urinary Retention in Adults: Evaluation and Initial Management](https://www.aafp.org/content/dam/brand/aafp/pubs/afp/issues/2018/1015/p496-f2.gif)
Urinary Retention in Adults: Evaluation and Initial Management
![Urinary Retention in Adults: Evaluation and Initial Management](https://image.slidesharecdn.com/anith-acuteurinaryretention-151022024229-lva1-app6892/85/acute-urinary-retention-2-320.jpg?cb=1666115730)
Acute Urinary Retention
![Urinary Retention in Adults: Evaluation and Initial Management](https://www.ebmedicine.net/_pathway_files/fd3754403e7644d5b5b5573cdc06ae13/42ff3a09-3851-4034-a401-ba0039e13394_Table-1-Major-Causes-of-Acute-Urinary-Retention.png)
Management of Acute Urinary Retention in the Emergency Department
![Urinary Retention in Adults: Evaluation and Initial Management](https://www.mdpi.com/jpm/jpm-12-00968/article_deploy/html/images/jpm-12-00968-g001.png)
JPM, Free Full-Text
![Urinary Retention in Adults: Evaluation and Initial Management](https://media.springernature.com/full/springer-static/image/art%3A10.1038%2Fpcan.2015.15/MediaObjects/41391_2015_Article_BFpcan201515_Fig1_HTML.jpg)
Systematic review and meta-analysis on management of acute urinary
![Urinary Retention in Adults: Evaluation and Initial Management](https://journals.sagepub.com/cms/10.1177/21925682221146493/asset/images/large/10.1177_21925682221146493-fig6.jpeg)
Risk Factors for Postoperative Urinary Retention Following Lumbar Spine Surgery: A Review of Current Literature and Meta-Analysis - Logan A. Reed, Alexander K. Mihas, Travis A. Fortin, Connor J. Donley, Guna Pratheep
![Urinary Retention in Adults: Evaluation and Initial Management](https://www.frontiersin.org/files/Articles/464215/fped-07-00298-HTML-r1/image_m/fped-07-00298-g001.jpg)
Frontiers Diagnosis and Management of Bladder Dysfunction in
RACGP - Urinary incontinence
![Urinary Retention in Adults: Evaluation and Initial Management](https://teachmesurgery.com/wp-content/uploads/2019/02/Screen-Shot-2019-02-14-at-23.07.22.png)
Acute Urinary Retention - Clinical Features - Management
![Urinary Retention in Adults: Evaluation and Initial Management](https://media.post.rvohealth.io/wp-content/uploads/2023/10/human-organ-anatomy-kidney-stones-732x549-thumbnail.jpg)
Urinary Retention: Causes, Treatment, and More
![Urinary Retention in Adults: Evaluation and Initial Management](https://www.myamericannurse.com/wp-content/uploads/2023/12/shutterstock_2020357304-1-1024x683.jpg)
UTI revisited: Optimizing best practices
![Urinary Retention in Adults: Evaluation and Initial Management](https://dm3omg1n1n7zx.cloudfront.net/rcni/static/journals/ns/aop/ns.2021.e11594/tile/ns.2021.e11594_abs.jpg)
Use of indwelling catheters and preventing catheter-associated urinary tract infections
![Urinary Retention in Adults: Evaluation and Initial Management](https://img.medscapestatic.com/pi/meds/ckb/16/39916tn.jpg)
Urinary Incontinence: Practice Essentials, Background, Anatomy
from
per adult (price varies by group size)