Common Urinary Retention exam questions for medical finals, OSCEs and MRCP PACES
List three drugs you should specifically ask a patient in urinary retention:
- Tricyclic medication
- Anti-muscarinic medication
- Cold and flu remedies
What are the treatments for BPH?
- Avoid caffeine and alcohol, regular voiding, distraction methods and bladder training
- Alpha blockers such as Tamsulosin, 5-alpha reductase inhibitors e.g. finasteride
- Transurethral resection of prostate (TURP), transurethral incision of prostate (TUIP), retropubic prostatectomy, transurethral laser-induced prostatectomy.
How should you investigate and treat acute urinary retention?
- Full history and examination
- Urine dip and MSU
- U&Es, FBC and clotting (G&S if frank haematuria)
- Blood glucose
- Consider PSA if suspicious prostate
- Post-catheter: Measure residual volume of bladder in first 10-15 minutes
- Residual volumes of greater than one litre make patients more likely to fail a trial without catheter (TWOC) and increase the chances of have recurrent retention
- Post-catheterisation patients may be admitted if they have:
- Clot retention
- Complicated renal colic
- Frank haematuria
- Social reasons or lots of co-morbidities
- Greater than two litres of residual urine
- Post-catheterisation patients may be sent home if they have none of the issues above