Acute urinary retention
- Glen W Barrisford, MD, MS
Glen W Barrisford, MD, MS
- Director of Urologic Oncology
- Santa Rosa Medical Center
- Kaiser Permanente
- Graeme S Steele, MBBCh, FCS
Graeme S Steele, MBBCh, FCS
- Assistant Professor of Surgery
- Harvard Medical School
- Section Editors
- Michael P O'Leary, MD, MPH
Michael P O'Leary, MD, MPH
- Section Editor — Urology
- Professor of Surgery, Harvard Medical School
- Senior Urologic Surgeon, Brigham and Women's Hospital
- Robert S Hockberger, MD, FACEP
Robert S Hockberger, MD, FACEP
- Section Editor — Adult Signs and Symptoms
- Emeritus Professor of Medicine
- David Geffen School of Medicine at UCLA
Acute urinary retention (AUR) is the inability to voluntarily pass urine. It is the most common urologic emergency . In men, AUR is most often secondary to benign prostatic hyperplasia (BPH); AUR is rare in women [2,3].
This topic will review the epidemiology, pathogenesis and etiology, clinical presentation, evaluation, diagnosis, acute management, and subsequent evaluation and management of AUR. The diagnosis and treatment of BPH are discussed separately. (See "Clinical manifestations and diagnostic evaluation of benign prostatic hyperplasia" and "Medical treatment of benign prostatic hyperplasia" and "Transurethral procedures for treating benign prostatic hyperplasia".)
Acute urinary retention (AUR) is common in men. The incidence increases with age, occurring most frequently in men over age 60 [2-5]. It is estimated that, over a five-year period, approximately 10 percent of men over the age of 70 and almost one-third of men in their 80s will develop AUR [2,3,6].
PATHOGENESIS AND ETIOLOGIES
A variety of pathophysiologic mechanisms may be responsible for the development of acute urinary retention (AUR). These mechanisms may overlap within any specific etiology.
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- PATHOGENESIS AND ETIOLOGIES
- CLINICAL PRESENTATION
- ACUTE MANAGEMENT
- Options for bladder decompression
- - Urethral catheterization
- Indwelling catheter
- Clean intermittent catheterization
- - Suprapubic catheter
- Rate of decompression
- Complications of decompression
- Duration of catheterization
- Other treatments
- Indications for hospitalization
- SUBSEQUENT MANAGEMENT
- Benign prostatic hyperplasia
- - Medical management
- - Trial without a catheter
- - Surgical therapy
- Other conditions
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS