Acute Urinary retention (AUR) in Female

Female AUR Topic
FB Dr Soarawee
Soarawee Weerasopone, MD

Minimally Invasive Uro-Oncologist
Royal Phnom Penh hospital, Kingdom of Cambodia

First, I must say that female urinary retention is a quite rare condition if we’re comparing to a male gender. There was a literature showing that the incidence ratio between female and male as low as 1:13. The explanation is that the female doesn’t have a prostate gland which is possibly obstructing the urethra when they are getting older like male did. Anyway, when the female in AUR happen, it’s always a difficult issue for non-expert one to handle with. This topic will mainly discuss about the female in AUR.

AUR patient
Acute urinary retention in female is quite difficult issue in non-expert physician.

The etiology of female urinary retention is a complex issues and always multifactorial causes so we must carefully manage step by step. From my general practicing, I categorized the decision making into 2 episodes.

Female urinary retention is possibly caused from multifactorial which need to treat step-by-step.
Female urinary retention is possibly caused from multifactorial which need to treat step-by-step.

Episodes of Female urinary retention

  1. Acute episode – Female in AUR that just happened for the first time or just symptomatic presenting less than 6 weeks.
    • I always consider it as a reversible female in AUR and need to find out the correctable causing.
    • Mostly, it will be found in postpartum period or who underwent the urologic anti-incontinence surgery.
  2. Chronic episode – Still remaining female in AUR even it’s been fixed all the correctable causing, so we must consider it as a chronic episode. The causes of chronic female in AUR must be divided into 2 categories.
    • Bladder-causes – for example neurogenic bladder, underactive bladder.
    • Bladder outlet obstruction – for example gynecological tumor, urethral tumor or even pregnancy.
Chronic female urinary retention will be considered if fail to reverse.
Chronic female urinary retention will be considered if fail to reverse.

The questions came up with; what’s the proper management during the AUR period? The answer is “bladder decompression”. Bladder decompression method will let the bladder rest after ballooning exceed their limits (The bladder contraction mechanism normally run by a complicated nerve-involving signal, when it is ballooning too much, the nerve surrounding the bladder becomes injured and need to take some rest).

So, the female in AUR treatment’s method will take place step by step as showing below

  • Bladder decompression method with urethral catheterization or intermittent catheterization.
  • Find the exact etiology that make female in AUR and correct it.
  • Continue bladder decompression method 1 – 14 days and then let the patients urinate by themselves.
  • If everything going well and smoothly, it is all right. If still inability to urinate, so to continue the bladder decompression and reassess the clinical once again.
Urethral catheter is considered when female urinary retention is suspected.
Urethral catheter is considered when female urinary retention is suspected.

The latest paper shows 92.6% success rate after well-corrected the etiology of female in AUR so don’t be panic with this kind of symptom which happens to you. Any questions, please consider making a discussion with your trusted urologist or it would be my honor if you text me. Take care!

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