Urinary Retention and Post-Void Residual Urine in Men: Separating Truth From Tradition

Kaplan, Steven A.; Wein, Alan J.; Staskin, David R.; Roehrborn, Claus G.; Steers, William D.

doi:10.1016/j.juro.2008.03.027

Cited by 133 publications

(93 citation statements)

References 54 publications

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“…There are no clear defining characteristics of urinary retention, such as a specific volume of urine or elapsed time postoperatively without micturition; however, in accordance with the consensus view in the contemporary literature, urinary retention would be described as an inability to initiate micturition with a bladder volume exceeding 500 mL. 6 Urinary retention can be complete or partial, acute or chronic, painful or silent, obstructive or non-obstructive. ''Overflow'' incontinence secondary to excess intravesical pressure can occur.…”

Section: Résumémentioning

confidence: 99%

“…The long-term consequences of postoperative urinary retention (POUR) are not always immediately apparent in the perioperative period, although increased hospital length of stay and prolonged detrusor dysfunction have been documented. 1,6 Neuraxial local anesthetics block the afferent and efferent limbs of the micturition reflex resulting in detrusor dysfunction and the inability to sense a full bladder, thus impairing micturition. Neuraxial opioids enhance this effect by decreasing the sensation of bladder fullness, thus increasing bladder capacity and weakening detrusor contraction through their actions at the spinal level and in the pontine micturition centre.…”

Section: Résumémentioning

confidence: 99%

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Neuraxial anesthesia and bladder dysfunction in the perioperative period: a systematic review

Choi

Mahon

Awad

2012

Can J Anesth/J Can Anesth

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Purpose Urinary retention requiring catheterization carries the risk of infection. Neuraxial anesthesia causes transient impairment of bladder function ranging from delayed initiation of micturition to frank urinary retention. We undertook a review of the literature to determine the elements of neuraxial anesthesia and analgesia that prolong bladder dysfunction and increase the incidence of urinary retention. Methods We performed a systematic search of the PubMed, MEDLINE, and EMBASE databases (from January 1980 to January 2011) to identify studies where neuraxial anesthesia and/or analgesia were employed and at least one of the following outcomes was reported: urinary retention, time to micturition, or post void residual. We included randomized controlled trials and observational studies published in the English language and we excluded case reports. The randomized trials were graded according to the Jadad score. Principal findings Our search yielded 94 studies, and in 16 of these studies, the authors reported time to micturition after intrathecal anesthesia of varying local anesthetics and doses. Intrathecal injections were performed in 41 of these studies, epidural anesthesia/analgesia was used in 39 studies, and five studies involved both the intrathecal and epidural routes. Meta-analysis was not possible because of the heterogeneity of interventions and reported outcomes. The duration of detrusor dysfunction after intrathecal anesthesia is correlated with local anesthetic dose and potency. The incidence of urinary retention displays a similar trend and is further increased by the presence of neuraxial opioids, particularly long-acting variants. Urinary tract infection secondary to catheterization occurred rarely. Conclusions Neuraxial anesthesia/analgesia results in transient detrusor dysfunction. The duration of dysfunction depends on the potency and dose of medication used; however, it does not appear to result in significant morbidity.

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Section: Résumémentioning

confidence: 99%

Section: Résumémentioning

confidence: 99%

Neuraxial anesthesia and bladder dysfunction in the perioperative period: a systematic review

Choi

Mahon

Awad

2012

Can J Anesth/J Can Anesth

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“…Although many etiologic factors have been identified (which are classified under three main categories: obstructive, neurogenic and myogenic), BPH is thought to be the most prevalent. [2] The exact causative mechanism of AUR remains under debate. [8] Several community-and population-based studies have clearly demonstrated that the incidence of AUR increases with age, particularly in men over age 70.…”

Section: Discussionmentioning

confidence: 99%

“…[1] AUR may develop into urinary infection, permanent bladder dysfunction and even renal insufficiency. [2][3][4] The most common cause of obstructive AUR is benign prostatic hyperplasia (BPH). [3] Because of the age-dependent nature of BPH, the risk of AUR increases with age (10-30% with every 5-year age increase).…”

Section: Introductionmentioning

confidence: 99%

The risk factors for acute urinary retention in patients with benign prostatic hyperplasia

Demirel¹,

Gökkaya²,

Özden³

et al. 2012

Turkish Journal of Urology

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ÖZETAmaç: Akut üriner retansiyonun (AUR) ensık sebebi benign prostat hiperplazisidir(BPH). AUR'un etyolojisini ayrıntılı bir şekilde araştırmak için, BPH'lı hastalarda AUR ve histolojik prostatik inflamasyon ilişkisini değerlendirdik. Gereç ve Yöntem:Çalışmaya Ocak-Aralık 2008 tarihleri arasında BPH'ne bağlı AUR veya alt üriner sistem semptomları (AÜSS) nedeniyle trans üretral rezeksiyon-prostat (TURP) yapılan 226 hasta dahil edildi. Hastalar AUR(+) (n=89) ve AUR(-) (n=137) olmak üzere 2 gruba ayrıldı. Bu iki grup; yaşlarına, rezeke edilen prostat dokusu ağırlığına (Rt), total prostat spesifik antijen (tPSA) düzeylerine ve prostat dokusu patolojisinde inflamasyon varlığına göre karşılaştırıldı. AUR için bağımsız risk faktörleri lojistik regresyon analizi ile değerlendirildi ve P değeri <0.005 ise anlamlı olarak kabul edildi. Bulgular: Bu 226 hastanın ortalama yaşları 67.7±7.7 yıl, ortalama tPSA değeri 6.45±4.97 ng/ml, ortalama rezeke edilen prostat ağırlığı (Rt) 25.47±21.77 gr. idi. Ortalama yaş ve ortalama Rt, AUR(+) grubunda diğer gruba göre anlamlı olarak daha fazla idi (p<0.0001 ve p= 0.031). Prostatik inflamasyonu olan hastalarda AUR gelişme riski olmayanlara göre anlamlı olarak daha yüksek bulundu (p= 0.049). Yapılan lojistik regresyon analizinde, 70 yaşın üzerinde, 25 gr'dan fazla doku çıkarılması ve prostatik inflamasyon varlığı AUR gelişiminde bağımsız risk faktörleri olarak bulundu.Sonuç: Sonuçlarımız göstermektedir ki; BPH'li hastalarda 70 yaşın üzerinde olmak, 25 gr'dan fazla doku çıkarılması ve prostatik inflamasyon varlığı AUR gelişiminde bağımsız risk faktörleridir.Anahtar sözcükler: Akut üriner retansiyon; benign prostat hiperplazisi; alt üriner sistem semptomları; prostat spesifik antijen. ABSTRACT Objective:The most common cause of obstructive acute urinary retention (AUR) is benign prostatic hyperplasia (BPH). To investigate the etiology of AUR, we evaluated the relationship between AUR and histological prostatic inflammation in patients with BPH. Materials and Methods:Between January and December of 2008, 226 patients who underwent transurethral resection of prostate (TURP) for AUR or lower urinary tract symptoms (LUTS) as a result of BPH were included in the study. Patients were classified into AUR(+) (n=89) and AUR(-) (n=137) groups. The two groups were compared along the following dimensions: age, weight of resected prostatic tissue (Rt), total prostate specific antigen (tPSA) levels and the presence of inflammation in the prostatic pathology. Independent risk factors for AUR were evaluated using logistic regression analysis. P values <0.05 were considered significant. Results:The mean age of the 226 patients was 67.7±7.7 years; the mean tPSA level was 6.45±4.97 ng/ml; and the mean weight of resected prostatic tissue (Rt) was 25.47±21.77 g. The mean age and Rt of the AUR(+) group were significantly higher than those of the AUR(-) group (p<0.0001 and p= 0.031, respectively). The odds of AUR were significantly higher in the patients with inflammation than in those without (p= 0.049). An age ...

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“…Further studies are needed to determine the usefulness of urine culture as screening methods and the correlation between symptomatic UTI and stricture recurrence. Ultrasound PVR measurement is noninvasive technique that provide objective measurement of bladder emptying [24]. One may predict that high PVR volume would predict stricture.…”

Section: Urethral Stricturementioning

confidence: 99%

Urethroplasty; Wide Range of Therapeutic Indications and Surgical Techniques

Mustafa¹,

Abugaber²,

Nurigorgel³

et al. 2011

Current Concepts of Urethroplasty

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Urinary Retention and Post-Void Residual Urine in Men: Separating Truth From Tradition

Cited by 133 publications

References 54 publications

Neuraxial anesthesia and bladder dysfunction in the perioperative period: a systematic review

Neuraxial anesthesia and bladder dysfunction in the perioperative period: a systematic review

The risk factors for acute urinary retention in patients with benign prostatic hyperplasia

Urethroplasty; Wide Range of Therapeutic Indications and Surgical Techniques

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