One of a Urologic emergency condition that we are going to discuss today is an acute urinary retention. The condition is most prevalent and common in male patient rather than the female. So the topic wills mainly focusing on the acute urinary retention in male patients. Typically, it happens in older gentleman who over 60 years and they were the most often group that realized and faced the condition of symptom. The following risks factors below shall have considered while the patients suffering from it;
- Benign Prostatic Hyperplasia (BPH) – The most common risk factor that the older gentleman cannot be avoided or ignored. It is the enlargement of the prostate gland. Typically, it gradually onset of a poor urinary stream in men who over 50 years old up. The proper treatment from Urologist is capable to minimize the risk of urinary retention in the coming future.
- Urethral stricture – Having history of urethral infection, STDs or Endoscopic urological procedure might induce a urethral scarring process which will makes urethral lumen narrowing and finally obstructed.
- Urethral stone – A rare condition which is occurred by urinary tract stone occluded inside the urethral lumen and that would need an emergency evacuation.
- Infections – Bladder infection, prostate infection or urethral infection can make a severe irritation in these areas and as results the acute urinary retention may remain.
- Medications – For on medication recently, it capable to interfere and void the function and when stop the certain drugs, the acute urinary retention will be resolved immediately.
- Constipation – What a surprise that just-a-simple problem can end up the acute urinary retention. Why? Because of the stool in your rectum compacted the urethra and cause it difficulty.
- Limited ambulation – Voiding mechanism is more complex than we’ve thought. The bladder is controlled by the brain. The brain will allow men to void in the peacefully quiet places and in-standing position. So we can see a lot of patient who remain in bed always complaint about the retention of urinating but literally, it is easily to solve by just encourage them to do the walking ambulation.
- Neurological causes – A complicated condition that should be needed more carefully assessment by Urologist.
- Bladder dysfunction – Another rare bladder condition which cannot contract well and end up with full bladder.
An urgent management which we had always performed is the bladder decompression with urethral catheter or suprapubic tube insertion to release a large amount of the urines from the bladder before it becomes rupture. Then the certain treatment will be depended and done by a well-trained Urologist. Patient must be educated about plan of the treatment and the possibility causes of the retention. The most important thing is we should let the patient knows and understand the overview of the conditions aspect. A few complications condition after release or draining a huge amount of the urines like causing bloody urinating, perhaps made the patients goosebumps for example, it should be told or advice to the patient in priority. Because it can helps some kind of panic or scared that the patients will receive.
Any questions, you can feel free to discuss with me.