From the Guidelines
For urinary retention, there is no recommended IV drip, as the primary treatment involves addressing the underlying cause and using oral medications such as alpha blockers. The provided evidence 1 focuses on the management of lower urinary tract symptoms attributed to benign prostatic hyperplasia, recommending oral alpha blockers prior to a voiding trial to treat patients with acute urinary retention (AUR) related to BPH. Key points to consider in the management of urinary retention include:
- Oral alpha blockers, such as alfuzosin or tamsulosin, have been shown to improve AUR signs and symptoms, as measured by trial without a catheter (TWOC) 1.
- Patients newly treated for AUR with alpha blockers should complete at least three days of medical therapy prior to attempting TWOC 1.
- Clinicians should inform patients who pass a successful TWOC for AUR from BPH that they remain at increased risk for recurrent urinary retention 1. Given the lack of evidence supporting the use of IV drips in the treatment of urinary retention, the focus should be on addressing the underlying cause and using oral medications as recommended by the guidelines 1.
From the Research
IV Drip for Urinary Retention
There are several IV drips that can be used to treat urinary retention, including:
- Neostigmine: a cholinesterase inhibitor that can help improve bladder function and reduce urinary retention 2, 3
- Bethanechol: a cholinergic agonist that can help improve detrusor contractility and reduce urinary retention 4
Key Considerations
When choosing an IV drip for urinary retention, it's essential to consider the underlying cause of the condition and the patient's individual needs. For example:
- Neostigmine may be more effective for postoperative urinary retention, while Bethanechol may be more suitable for patients with detrusor underactivity or urinary retention due to other causes 2, 4
- The choice of neuromuscular block reversal agent can also impact the risk of post-operative urinary retention, with sugammadex potentially being a better option than neostigmine plus glycopyrrolate 3
Treatment Options
The treatment of urinary retention typically involves a combination of catheterization, medication, and other interventions. Some key treatment options include: