Urinary Retention: A Cause of Hyponatremia?

Abstract

Background: Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is the most common cause of hyponatremia in elderly hospitalized patients; however in many patients the etiology remains unclear even after routine investigations. Objective: To report our experience of the association of hyponatremia and urinary retention in elderly hospitalized patients. Patients: Six patients with hyponatremia and urinary retention who were admitted to the geriatric department in our hospital during a four-year period (2001–2004). Results: The mean age of the patients was 85 years. The mean serum sodium level was 120 mEq/l, average volume of retained urine was 933 ml (range 500–1,500 ml). All patients underwent a comprehensive work-up seeking a possible cause for the hyponatremia. The diagnostic work-up was negative. In 5 of the patients the laboratory findings fulfilled the criteria for SIADH. In all patients hyponatremia resolved following urinary catheterization and fluid restriction. All patients made a complete recovery. Conclusions: Potentially, urinary retention by itself may cause hyponatremia. The possible mechanism for this is SIADH, triggered by bladder distention or pain due to bladder distention. Urinary catheterization may be the key to treatment in these cases of hyponatremia.

Urinary retention and syndrome of inappropriate antidiuretic hormone secretion (SIADH) secondary to impacted gravid uterus

“…Interestingly, similarly to our case, this patient's sodium level normalized after catheterizing the bladder . These reports have suggested that the bladder distention associated with urinary retention can stimulate antidiuretic hormone (ADH) release from the posterior pituitary . It is also postulated that the hypersecretion of ADH may be mediated by the activation of the limbic system caused by the pain associated with bladder distention…”

“…Our patient is considered the first reported pregnant woman developing severe hyponatremia and SIADH secondary to an impacted retroverted uterus. Galperin et al . described five elderly hospitalized patients who developed urinary retention followed by hyponatremia and confirmed SIADH.…”

“…8 These reports have suggested that the bladder distention associated with urinary retention can stimulate antidiuretic hormone (ADH) release from the posterior pituitary. 7,8 It is also postulated that the hypersecretion of ADH may be mediated by the activation of the limbic system caused by the pain associated with bladder distention. 9 Acute severe hyponatremia can result in dangerous brain effects leading to coma and death.…”

Urinary Retention as a Cause of Hyponatremia in an Elderly Man

“…Our patient had chronic retention of urine due to urethral stricture. It has been postulated that chronic urinary retention and subsequent bladder distension can stimulate ADH release from the posterior pituitary, producing a clinical picture similar to SIADH [6,7]. Although urinary retention may improve marginally with medications, surgical management can give a much better relief.…”

No toda la culpa fue de la COVID

“…Existen pocos casos descritos en la literatura 3 , 4 , 5 , 6 , 7 . Se cree que la distensión vesical produce una liberación de vasopresina a nivel hipofisario 8 .…”