Female Urinary Retention – Observations from a Retrospective Case Note Review

Main Article Content

Aman Harbias
Ayooluwa Olateju
Thiruendran Gunendran
Richard Montague

Abstract

Background and Objective
There are no current guidelines to manage female retention patients. We aimed to see if a standardized approach could be used to manage these patients.


Methods
Between October 2014 and September 2016, all female patients with urinary retention admitted under a urology consultant were reviewed.



Results
A total of 46 females had a single episode of urinary retention whilst 19 females had recurrent episodes. The commonest cause for a single episode of retention was attributed to anesthesia (general/spinal) (n=9), constipation (n=9) and medication use (n=4). Most of these women (95%) voided on the first attempt fol-lowing catheter removal. In the absence of any neurological symptoms, pelvic ultrasound was the only investigation that revealed any underlying pathology in female retention patients. A pelvic mass was identi-fied in 3 (4.5%) patients.



Conclusion
Females with an isolated episode of retention, with an obvious precipitating cause identified during full history and examination, could proceed directly to a nurse-led trial of catheter removal without the need for any further urology review. Others should undergo a pelvic ultrasound and review by a urologist. In our opinion, females with recurrent unexplained episodes of urinary retention should be referred for a trial of sacral neuromodulation if considered appropriate.

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Article Details

How to Cite
Harbias, A., Olateju, A., Gunendran, T., & Montague, R. (2020). Female Urinary Retention – Observations from a Retrospective Case Note Review . Journal of Endoluminal Endourology, 3(2), e5-e15. https://doi.org/10.22374/jeleu.v3i2.82
Section
Original Article

References

1. Klarskov P, Andersen J, Asmussen C, Brenoe J, Jensen S, Jensen I, et al. Acute urinary retention in women: A prospective study of 18 consecutive cases. Scand J Urol Nephrol 1987;21:29–31.
2. van der Linden EF, Venema PL. [Acute urinary re-tention in women]. Ned Tijdschr Geneeskd 1998 Jul;142(28):1603–6.
3. Mevcha A, Drake MJ. Etiology and management of urinary retention in women. Indian J Urol [Internet] 2010;26(2):230–5. Available from: http://www.indian jurol.com/article.asp?issn=0970-1591;year=2010; volume=26;issue=2;spage=230;epage=235;aulast=mevcha
4. Basson J, Van Der Walt C, Heyns CF. Urinary retention in women. Contin Med Educ 2012;30(5):160–2.
5. Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. The standardisation of terminology in lower urinary tract function: Report from the standardi-sation sub-committee of the International Continence Society. Urology 2003;61(1):37–49.
6. Lee SJ, Kim YT, Lee TY, Woo YN. Analysis of Risk Factors for Acute Urinary Retention after Non-urogenital Surgery. Korean J Urol [Internet] 2007 Dec;48(12):1277–84. Available from: http://synapse.koreamed.org/DOIx.ph p?id=10.4111%2Fkju.2007.48.12.1277
7. Baldini G, Bagry H, Aprikian A, Carli F. Postoperative urinary retention: anesthetic and perioperative consid-erations. Anesthesiology 2009 May;110(5):1139–57.
8. Özveren B, Keskin S. Presentation and prognosis of female acute urinary retention: Analysis of an unusual clinical condition in outpatients. Urol Ann [Internet] 2016 Jun 17;8(4):444–8. Available from: http://www .ncbi.nlm.nih.gov/pmc/articles/PMC5100150/
9. Carley ME, Carley JM, Vasdev G, Lesnick TG, Webb MJ, Ramin KD, et al. Factors that are associated with clinically overt postpartum urinary retention after vaginal delivery. Am J Obstet Gynecol 2002 Aug;187(2):430–3.
10. Geller EJ. Prevention and management of postoperative urinary retention after urogynecologic surgery. Int J Womens Health 2014;6(1):829–38.
11. Bouhours AC, Bigot P, Orsat M, Hoarau N, Descamps P, Fournie A, et al. [Postpartum urinary retention]. Prog Urol 2011 Jan;21(1):11–7.
12. Cavkaytar S, Kokanalı MK, Baylas A, et al. Postpartum urinary retention after vaginal delivery: Assessment of risk factors in a case-control study. J Turkish German Gynecol Assoc 2014;15(3):140–43. doi:10.5152/ jtgga.2014.13102
13. Ramsey S, Palmer M. The management of female uri-nary retention. Int Urol Nephrol 2006;38(3–4):533–5. 14. Ahmad I, Krishna NS, Small DR, Conn, IG. Aetiology and management of acute female urinary retention. Br
J Med Surg Urol 2009;2:27–33
15. Nitti VW, Tu LM, Gitlin J. Diagnosing Bladder Outlet Obstruction in Women. J Urol 1999;161(5):1535–40.
16. Cormier L, Ferchaud J, Galas JM, Guillemin F, Mangin P. Diagnosis of female bladder outlet obstruction and relevance of the parameter area under the curve of detrusor pressure during voiding: preliminary results.
J Urol 2002;167(5):2083–7.
17. Ryuji S, Tomoyuki U, Yusuke A, et al. Psychogenic
urinary dysfunction: A uro-neurological assessment. Neurourol Urodyn [Internet] 2007 Mar 13;26(4):518–24. Available from: https://doi.org/10.1002/nau.20321
18. Fowler CJ, Kirby RS. Abnormal electromyographic activity (decelerating burst and complex repetitive dis-charges) in the striated muscle of the urethral sphincter in 5 women with persisting urinary retention. Br J Urol 1985 Feb;57(1):67–70.
19. Osman NI, Esperto F, Chapple CR. Detrusor under-activity and the underactive bladder: a systematic review of preclinical and clinical studies. Eur Urol 2018;74(5):633–43.
20. Cohn JA, Brown ET, Kaufman MR, Dmochowski RR, Reynolds WS. Underactive bladder in women: is there any evidence? Curr Opin Urol 2016;26(4):309–314. doi:10.1097/MOU.0000000000000280
21. Kavia RBC, Datta SN, Dasgupta R, Elneil S, Fowler CJ. Urinary retention in women: Its causes and manage-ment. BJU Int 2006;97(2):281–7.
22. Fowler CJ, Kirby RS, Harrison MJ. Decelerating burst and complex repetitive discharges in the striated muscle of the urethral sphincter, associated with urinary reten-tion in women. J Neurol Neurosurg Psychiatry [Internet] 1985 Oct;48(10):1004–9. Available from: http://www .ncbi.nlm.nih.gov/pmc/articles/PMC1028539/
23. Swinn MJ, Wiseman OJ, Lowe E, Fowler CJ. The cause and natural history of isolated urinary retention in young women. J Urol [Internet] 2002 Jan 1 [cited 2018 Jul 8];167(1):151–6. Available from: https://www.science direct.com/science/article/pii/S002253470565402X