Retenção urinária aguda em pré‐escolar feminina com constipação intestinal

Abstract

Objective:To report a case of a preschool girl who developed acute urinary retention associated with constipation.Case description:A girl aged six years old presented a 24 h history of inability to urinate. She was went twice to the emergency room during this period. In the first admission, 12 h after the onset of the symptoms, she presented abdominal pain and acute urinary retention. After the drainage by urinary catheterization of 300 mL of clear urine, she presented relief of the symptoms and, as urinalysis had no change, the patient was discharged home. Twelve hours after the first visit, she returned to the emergency room complaining about the same symptoms. At physical examination, there was only a palpable and distended bladder up to the umbilicus with no other abnormalities. Again, a urinary catheterization was performed, which drained 450 mL of clear urine, with immediate relief of the symptoms. Urinalysis and urine culture had no abnormalities. During the anamnesis, the diagnosis of constipation was considered and a plain abdominal radiography was performed, which identified large amount of feces throughout the colon (fecal retention). An enema with a 12% glycerin solution was prescribed for three days. During follow-up, the child used laxatives and dietary modifications, this contributed to the resolution of the constipation. There were no other episodes of urinary retention after 6 months of follow-up.Comments:Acute urinary retention in children is a rare phenomenon and constipation should be considered as a cause.

An Unusual Cause of Acute Urinary Retention

“…Constipation is an atypical cause of acute urinary retention in adults and is rarely mentioned in the literature. 4 A sigmoid colon diameter of 6.5 cm at the pelvic brim is commonly used as a discriminating point for diagnosing megacolon. 5 Treatment for severe chronic constipation and fecal impaction typically includes manual disimpaction and enemas, or oral solutions containing polyethylene glycol.…”