Urinary retention

This is a slightly different form of urine retention. Well, really it's just keeping it in a bottle.

Definition

Not passing wee. Anuria is not passing any urine. Oliguria is passing very small amounts.

Epidemiology

Differential Diagnosis

• Neuro - MS, spinal injury (including prolapsed disc)
• Kidney - ARF
• Bladder - damage due to trauma or surgery
• Prostate - cancer, BPH, prostatitis
• Urethra - structural abnormality
• Drugs - anticholinergics, NSAIDs, stimulants (MDMA, speed)

Clinical and Associated Features

• Neuro
  • Spinal injury - you get a spinal injury
  • MS - basically, a series of temporary neurological deficits, becoming longer and more frequent (eventually permanent). Urinary problems is one of these deficits but optic neuritis is common plus any other neurological deficit. Must be 'disseminated in time and place' i.e. different locations for the lesions, not related in time.
• Bladder - you don't wee. Might get abdominal pain and urgency as the wee builds up.
• Urethral blockage - oliguria, spraying/double-stream, dribbling, sometimes urinary frequency, UTI, mild dysuria
• Prostate
  • Cancer - dysuria, hesitancy/retention, haematuria, haematospermia (blood in sperm), pain (back, perineal, testicular), constipation. Secondary signs: bone - pain, fracture, hypercalcaemia, lower limb neurological deficit; jaundice; seizures; oedema. General features: weight loss, anorexia, fever.
  • Prostatitis - perineal pain, frequency, urgency, haematuria, pain on defaecation. Can progress to chronic prostatitis if treated poorly.
  • Benign prostatic hyperplasia - see prostatitis plus flattened surface on DRE.
• Drugs - any of the mentioned ones might give you a bit of the ol' urinary retention.