Incidence and risk factors for urinary retention in critically ill patients

Abstract

Background: The removal of an indwelling urinary catheter is indicated as soon as possible to prevent complications. However, acute urinary retention is little studied among intensive care patients. Aims: The aim of this study was to determine the incidence and risk factors for acute urinary retention after the removal of an indwelling urinary catheter in critically ill patients. Design: This single-centre prospective study included adult critically ill adult surgical and medical patients. Methods: All patients had an indwelling catheter for more than 48 h and indication of its removal by the attending physician. Acute urinary retention was defined as a bladder volume greater than 400 mL determined by ultrasound or intermittent urinary catheterization. A multivariate logistic regression was performed to analyse the possible risk factors for acute urinary retention. Results: We included 85 patients from July 2014 to May 2015, most of them surgical (71⋅8%). Acute urinary retention occurred in 26 patients (30⋅6%). The use of hypnotics (midazolam or propofol given as continuous infusion) [OR 14⋅87 (95% CI 1⋅32-167⋅79); p = 0⋅029], indwelling catheterization for more than 7 days [OR 9⋅87 (95% CI 2⋅97-32⋅85); p < 0⋅001] and bed restraint [OR 9⋅43 (95% CI 1⋅07 to 83⋅33); p = 0⋅043] were all independent risk factors for acute urinary retention. Conclusion: The incidence of acute urinary retention is high, and the main risk factors for its occurrence are prolonged use of urinary indwelling catheter, bed confinement and the use of hypnotics. Relevance to Clinical Practice: Patients with risk factors should be kept under surveillance after the removal of indwelling urinary catheter for early identification of acute urinary retention and thus prevention of related complications.

Effect Observation on Modified Zishen Tongguan Decoction Combined with Acupuncture in Treatment of Urinary Retention after Cervical Cancer Surgery and Its Influence on the Incidence of Adverse Reactions

“…Polyporus umbellatus plays a role of inducing diuresis and curing edema. Polyporus polysaccharide injection was subcutaneously injected to rats by some scholars [ 22 ], and significant increase of urine volume was found in the rats. The combined use of the above herbal medicine can make patients' kidney-qi sufficient, bladder gasification normal, and urination smooth.…”

Urinary Retention and Severe Hyponatremia: An Unusual Presentation of COVID-19

“…Our patient presented with urinary retention for the first time, but his normal US and I-PSS score of zero excluded urinary outlet obstruction as a possible cause of his hyponatremia and urinary retention. Additionally, urinary retention in critically ill patients can be explained by bed confinement and the use of hypnotics in hospital [9] . This was not the case in our patient who denied difficulty ambulation at home, and urinary retention was discovered in the emergency department.…”

Vantagens da ultrassonografia de bexiga na mensuração do volume urinário em pacientes críticos: revisão integrativa [Advantages of bladder ultrasound in measuring urine volume in critically ill patients: an integrative review] [Ventajas de la ecografía vesical en la medición del volumen urinario en pacientes críticos: revisión integradora]

“…Rev enferm UERJ, Rio de Janeiro, 2021; 29:e61972 p. 2 Early removal of the IUC is the main goal to be met within an ICU for the prevention of UTI, and it is necessary for the nurse to have essential knowledge and skills for managing UR after removal of the device. Lack of dexterity in the issue incurs in health problems; it is common to find UR after IUC removal in ICUs, a fact that is probably linked to the lack of skill in applying the physical examination and Nursing diagnosis, as well as to the absence of institutional protocols and professional training for patient monitoring after catheter removal 1,[3][4][5] .…”

“…It is a common situation in patients whose critical condition exerts a direct influence on urinary control ability. Indwelling Urinary Catheters (IUCs) may be present in approximately 15% to 25% of these patients, due to urine monitoring, bladder irrigation and Urinary Retention (UR) treatment; and despite the assertive indications, the procedure can also cause complications such as Urinary Tract Infection (UTI), trauma during the procedure and urinary retention 1,2 .…”