From the Research
The first-line treatment for female urinary retention is clean intermittent catheterization (CIC). This involves inserting a thin, flexible tube through the urethra into the bladder to drain urine, typically performed 4-6 times daily. The procedure can be self-administered after proper training, using sterile or clean technique depending on the clinical situation. For acute retention, an initial in-and-out catheterization in a healthcare setting may be performed, followed by CIC if retention persists.
Key Considerations
- The underlying cause of retention should be investigated and addressed simultaneously, as urinary retention in women can result from neurological disorders, medications, pelvic floor dysfunction, or anatomical obstruction 1.
- CIC is preferred over indwelling catheters as it has lower rates of urinary tract infections and preserves bladder function 2, 3.
- Patients should be taught proper technique, hygiene measures, and signs of complications such as infection or trauma.
Management Approach
- Initial evaluation should involve a detailed history and physical examination, including measurement of postvoid residual (PVR) volume of urine 3.
- Diagnostic testing should include urine analysis and pelvic ultrasonography as baseline investigations, with further radiological and urodynamic tests required in specific situations 4, 1.
- Bladder decompression and correction of the underlying cause can help achieve spontaneous micturition in most patients 1.
Pharmacological Options
- Alpha-blockers such as tamsulosin 0.4 mg daily may be considered, though their effectiveness in women is less established compared to men 5.