URINARY RETENTION
Urinary retention is the inability to empty the bladder completely during attempts to void. Chronic urine retention often leads to overflow incontinence (from the pressure of the retained urine in the bladder). Residual urine is urine that remains in the bladder after voiding. In a healthy adult younger than age 60, complete
bladder emptying should occur with each voiding. In adults older than age 60, 50 to 100 mL of residual urine may remain after each void because of the decreased contractility of the detrusor muscle.
Urinary retention can occur postoperatively in any patient,particularly if the surgery affected the perineal or anal regions and resulted in reflex spasm of the sphincters. General anesthesia reduces bladder muscle innervation and suppresses the urge to void,impeding bladder emptying (Gray, 2000a, 2000b).
Pathophysiology
Urinary retention may result from diabetes, prostatic enlargement, urethral pathology (infection, tumor, calculus), trauma(pelvic injuries), pregnancy, or neurologic disorders such as cerebrovascular accident, spinal cord injury, multiple sclerosis, or Parkinson’s disease.Some medications cause urinary retention, either by inhibiting bladder contractility or by increasing bladder outlet resistance.Medications that cause retention by inhibiting bladder contractility include anticholinergic agents (atropine sulfate, dicyclomine hydrochloride [Antispas, Bentyl]), antispasmodic agents (oxybutynin chloride [Ditropan], belladonna, and opioid suppositories),and tricyclic antidepressant medications (imipramine [Tofranil],doxepin [Sinequan]). Medications that cause urine retention by increasing bladder outlet resistance include alpha-adrenergic agents (ephedrine sulfate,pseudoephedrine), beta-adrenergic blockers (propranolol), and estrogens.
Urinary retention is the inability to empty the bladder completely during attempts to void. Chronic urine retention often leads to overflow incontinence (from the pressure of the retained urine in the bladder). Residual urine is urine that remains in the bladder after voiding. In a healthy adult younger than age 60, complete
bladder emptying should occur with each voiding. In adults older than age 60, 50 to 100 mL of residual urine may remain after each void because of the decreased contractility of the detrusor muscle.
Urinary retention can occur postoperatively in any patient,particularly if the surgery affected the perineal or anal regions and resulted in reflex spasm of the sphincters. General anesthesia reduces bladder muscle innervation and suppresses the urge to void,impeding bladder emptying (Gray, 2000a, 2000b).
Pathophysiology
Urinary retention may result from diabetes, prostatic enlargement, urethral pathology (infection, tumor, calculus), trauma(pelvic injuries), pregnancy, or neurologic disorders such as cerebrovascular accident, spinal cord injury, multiple sclerosis, or Parkinson’s disease.Some medications cause urinary retention, either by inhibiting bladder contractility or by increasing bladder outlet resistance.Medications that cause retention by inhibiting bladder contractility include anticholinergic agents (atropine sulfate, dicyclomine hydrochloride [Antispas, Bentyl]), antispasmodic agents (oxybutynin chloride [Ditropan], belladonna, and opioid suppositories),and tricyclic antidepressant medications (imipramine [Tofranil],doxepin [Sinequan]). Medications that cause urine retention by increasing bladder outlet resistance include alpha-adrenergic agents (ephedrine sulfate,pseudoephedrine), beta-adrenergic blockers (propranolol), and estrogens.
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Unknown - Friday, 12 August 2011
