Acute urinary retention is the sudden and painful inability to pass urine despite having a full bladder. Often this issue requires emergency treatment with a urinary catheter. It differs from chronic urinary retention which is associated with an increased risk of residual bladder volume and can be painless. Patients with urinary retention can present in various ways; complete lack of voiding, incomplete bladder emptying or overflow incontinence.
Acute urinary retention is the most common urology emergency[1]. It is more prevalent in men than women with older men being especially at risk. Approximately 10% of men in their 70s and 33% of men in their 80s have reported at least one episode of acute urinary retention[2].
It is estimated that over a five-year period, approximately 1 in 10 men over the age of 70 and almost 1 in 3 men in their 80s will develop acute urinary retention[3]. Whereas each year approximately 3 in 100,000 women develop acute urinary retention[4].
Urinary retention can present in numerous ways and can be classified as obstructive, inflammatory, neurological, infectious and pharmacological.
The symptoms include the following:
To be able to urinate, all parts of the urinary tract need to work in the correct order. Urine flows from the kidneys, through the ureters into the bladder and then out via the urethra. Urinary retention can occur if there is a disruption to flow resulting from any narrowing or blockages.
A blockage can have many different causes:
Neurological causes of acute urinary retention are as equally common in men and women[5]. The autonomic nervous system and somatic nerves control the bladder and the urethra, but if there is an interruption along those pathways it can cause acute urinary retention. Although the issue may begin as acute, it can often result in chronic long-term catheterisation.
Up to 56% of patients who have suffered a stroke will experience urinary retention, primarily because of detrusor hyporeflexia[6]. Furthermore, up to 45% of patients with diabetes mellitus and 75 to 100% of patients with diabetic peripheral neuropathy will experience bladder dysfunction, which is likely to include urinary retention[7].
Acute urinary retention can be a symptom of an underlying concern or illness which needs to be treated or managed.
The most common cause of acute urinary retention is benign prostatic hyperplasia (BPH) which is prevalent in men over 50. Due to an ageing population, we are likely going to be seeing more cases of men with prostate enlargement and its side effects.
Acute urinary retention is painful and requires immediate intervention to decompress the bladder. This is done by inserting a foley catheter either via the urethra or suprapubically. By ensuring that the bladder is empty, the risk of infection and kidney damage is reduced.
How long the catheter stays in place depends on the cause of the issue. Often patients can be discharged the same day, but the patient will require further investigation as an outpatient to determine the cause and follow-up treatment.
Urinary retention can be extremely uncomfortable for patients and can lead to further complications. The issue needs to be addressed with catheterisation to reduce the risk of infection and kidney damage. Catheters can be placed either via the urethra or suprapubically.
Mediplus S-Cath™ System is a suprapubic catheter that is inserted via the abdominal wall. It can provide immediate relief from acute urinary retention when urethral catheterisation has failed or is contraindicated. With conditions such as prostate enlargement, which causes urethra blockages, suprapubic catheters provide a safe treatment that is more comfortable for the patient.
For more information about the S-Cath™ System see here: S-Cath™ System.
Company REG. NO. 2051641
Copyright © 2020 Mediplus Ltd.