Wednesday, April 5, 2017

Urinary Retention

R.E.B.E.L.EM - April 4, 2017 - Post Peer Reviewed By: Anand Swaminathan
"Background: The treatment of urinary retention is pretty straightforward; place either a Foley catheter or suprapubic catheter to decompress the bladder. What is less clear, and more often debated, is if we need to clamp the catheter after 200 – 1000mLs of urine output or just allow complete drainage. Historic teaching has been to do intermittent volume drainage to avoid complications such as hematuria, circulatory collapse, and worsening renal failure. I distinctly remember being taught this as a resident, but not sure that I ever evaluated the literature until recently...
Author Conclusion: “In this first randomized trial, no statistically significant difference was noted between gradual and rapid emptying of the bladder for urinary retention. Gradual emptying did not reduce the risk of hematuria or circulatory collapse. Therefore, there is no need to prefer gradual over rapid emptying, which is both easy and safe.”
Clinical Take Home Point: Rapid drainage of the bladder in urinary retention does not cause more hematuria requiring intervention, renal failure, or hemodynamic collapse compared to gradual drainage of the bladder."