Urinary retention: Difference between revisions
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Kingrajinix (talk | contribs) (New page: right|thumb|300px ===Definition=== Not passing wee. '''Anuria''' is not passing any urine. '''Oliguria''' is passing very small amounts. ===Epidemiology=== [[image:co...) |
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[[image: | [[image:weebottle.jpg|right|thumb|300px|This is a slightly different form of urine retention. Well, really it's just keeping it in a bottle.]] | ||
===Definition=== | ===Definition=== | ||
Not passing wee. '''Anuria''' is not passing any urine. '''Oliguria''' is passing very small amounts. | Not passing wee. '''Anuria''' is not passing any urine. '''Oliguria''' is passing very small amounts. | ||
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===Pathophysiology=== | ===Pathophysiology=== | ||
===Differential Diagnosis=== | ===Differential Diagnosis=== | ||
*Neuro - [[MS]], [[spinal injury]] (including [[prolapsed disc]]) | |||
*Kidney - [[ARF]] | |||
*Bladder - damage due to trauma or surgery | |||
*Prostate - [[prostate cancer|cancer]], [[BPH]], [[prostatitis]] | |||
*Urethra - structural abnormality | |||
*Drugs - [[anticholinergics]], [[NSAIDs]], stimulants ([[MDMA]], [[speed]]) | |||
===Clinical and Associated Features=== | ===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]], haemato[[sperm]]ia (blood in sperm), pain ([[back pain|back]], perineal, [[testicular pain|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. | |||
===Investigations=== | ===Investigations=== | ||
===Management=== | ===Management=== | ||
Latest revision as of 10:30, 23 December 2009
Definition
Not passing wee. Anuria is not passing any urine. Oliguria is passing very small amounts.
Epidemiology
Pathophysiology
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.