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Urinary Retention – Introduction

Our professional content originates from Melissa Fulton, RN, BSN, MSN, FNP, APRN-C, Certified MS Specialist, and other healthcare contributors.

In general, urinary retention is defined as the inability for the bladder to empty to completion. It may be a chronic or an acute condition experienced by men and women due to several health problems – including structural and neurological issues.

Post Void Residual

There is a lack of standardized guidance on the volume of urine retained in the bladder that constitutes urinary retention. However, an American Urological Association (AUA) white paper titled Non-Neurogenic Chronic Urinary Retention: Consensus Definition, Management Strategies, and Future Opportunities states that a reasonable definition of non-neurogenic chronic urinary retention (CUR) is a bladder volume > 300 ml documented twice in a 6-month period. Furthermore, it, classifies urinary retention as high-risk and low-risk plus symptomatic and asymptomatic.

Low-Risk

Examples of low-risk or asymptomatic urinary retention can be incomplete bladder emptying that does not put the patient at any significant additional health risks. In this case, there would be no evidence of hydronephrosis, and renal function would be well preserved.

High-Risk

As the words imply, a patient with high-risk urinary retention has incomplete bladder emptying that could, if not treated, cause the patient harm.

For example, urinary retention that results in hydronephrosis or fluid backing back up in the kidneys, resulting in less-than-optimal renal function, is considered high-risk.

A patient with high-risk urinary retention may present with:

      • Acute or chronic symptoms of lower abdominal pain
      • An elevated serum creatinine or GFR
      • Recurrent urinary tract infections
      • Urinary incontinence with or without skin breakdown

Treatment options for the high-risk urinary retention may include:

  • Decompression of the bladder, by insertion of a foley catheter or intermittent catheterization, is imperative to reduce the stress on the kidneys

  • Surgical Intervention

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