Urinary Retention – Introduction

Post Void Residual

There is a lack of standardised 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.

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.

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 catheterisation, is imperative to reduce the stress on the kidneys

• Surgical Intervention