How is postoperative urinary retention treated?
Treatment of POUR includes initiation of selective alpha blockade (i.e., tamsulosin) and bladder decompression with either an indwelling catheter or intermittent catheterization. A trial without catheterization is possible within 1 to 3 days of retention.
What is the cause of postoperative urinary retention?
In the postoperative period, urinary retention has two main causes. The first is mechanical obstruction of the urinary outflow tract, and the second is altered neural control of the bladder and detrusor mechanism, most commonly due to analgesic drugs [4].
What are the nursing measures for urinary retention?
Nursing Interventions for Urinary Retention
| Interventions | Rationales |
|---|---|
| Provide privacy | Privacy aids in the relaxation of urinary sphincters. |
| Encourage the patient to void at least every 4 hours. | Voiding at frequent intervals empties the bladder and reduces risk of urinary retention. |
What is urinary retention diagnosis?
Urinary retention is a condition in which you cannot empty all the urine from your bladder. Urinary retention can be acute—a sudden inability to urinate, or chronic—a gradual inability to completely empty the bladder of urine.
How common is postoperative urinary retention?
Urinary retention is common after anesthesia and surgery, reported incidence of between 5% and 70%. Comorbidities, type of surgery, and type of anesthesia influence the development of postoperative urinary retention (POUR).
What are postoperative complications?
Postoperative complications are problems which arise as a result of you having had surgery, which were not an intentional effect of the surgery.
What are risk factors for urinary retention?
Advanced age, male sex, joint replacement surgery, history of hypertension, and diabetes mellitus significantly increased the risk of urinary retention. In patients with these risk factors, careful postoperative urological management should be performed.
How do you test for urinary retention?
A health care professional may use urinary tract imaging tests such as an ultrasound, VCUG, MRI, or CT scan to find out what’s causing your urinary retention.
How do you measure urinary retention?
Diagnosis of Urinary Retention
- Health care professionals use your medical history, a physical exam, and a postvoid residual urine measurement to diagnose urinary retention.
- Your health care professional will perform a physical exam, including a check of your lower abdomen, a rectal exam, and a neurological evaluation.
What is the first step for a patient that has urinary retention?
Initial management of urinary retention involves assessment of urethral patency with prompt and complete bladder decompression by catheterization.
How long does postoperative urinary retention last?
The rate of prolonged POUR beyond 4 weeks is low, and therefore most retention can be expected to resolve spontaneously within 4-6 weeks. When POUR does not resolve spontaneously, more active management may be required.
What are the signs of urinary retention?
Chronic urinary retention
- the inability to completely empty your bladder when urinating.
- frequent urination in small amounts.
- difficulty starting the flow of urine, called hesitancy.
- a slow urine stream.
- the urgent need to urinate, but with little success.
- feeling the need to urinate after finishing urination.
What is Postoperative urinary retention (Pur)?
Postoperative Urinary Retention (PUR) is defined in various ways in literature; however the common point in these definitions is being not able to urinate while having a full urinary bladder (Changchien et al., 2007; Gonullu et al., 1994; Smith & Albazzaz 1996).
Can urinary retention after anorectal surgery be explained by physiologic mechanisms?
It has been hypothesized that this physiologic mechanism could explain urinary retention after anorectal surgery.
Which comorbidities influence Postoperative urinary retention?
Comorbidities, type of surgery, and type of anesthesia influence the development of postoperative urinary retention (POUR). The authors review the overall incidence and mechanisms of POUR associated with surgery, anesthesia and analgesia.
What is the difference between complete urinary retention and partial retention?
Whereas complete urinary retention is usually obvious, partial retention may be subtler to diagnose.