From the Guidelines
To treat urinary retention in females, intermittent catheterization is generally recommended for initial management, as it is a effective way to manage urinary retention while minimizing the risk of complications. This approach is supported by the most recent and highest quality study available, which emphasizes the importance of screening for urinary retention via bladder scan or straight catheterization, and treating those found to have urinary retention with intermittent catheterization 1.
When considering treatment options, it is essential to identify and address the underlying cause of urinary retention. Some possible causes of urinary retention in females include:
- Medication side effects, such as those caused by antihistamines, decongestants, or antidepressants
- Pelvic floor dysfunction
- Neurological conditions
- Complications from pelvic surgeries
- Pelvic organ prolapse
For acute retention, catheterization is often necessary, and intermittent self-catheterization is a viable option for initial management. Additionally, alpha-blocker medications such as tamsulosin or alfuzosin can help relax the urethral sphincter and improve voiding. Behavioral techniques like double voiding and timed voiding can also help manage incomplete emptying.
It is also important to consider alternative methods for bladder management, such as intermittent catheterization, which can be used for both males and females when appropriate 1. Proper diagnosis and treatment are crucial to prevent complications and improve quality of life for females with urinary retention.
In terms of specific treatment protocols, creating a protocol to standardize the diagnosis and management of postoperative urinary retention, including guidelines for nurse-directed intermittent catheterization and the utilization of bladder scanners, can help improve outcomes 1. Ultimately, the goal of treatment is to minimize morbidity, mortality, and improve quality of life, and intermittent catheterization is a key component of this approach.
From the Research
Treatment Options for Urinary Retention in Females
- The treatment of urinary retention in females depends on the underlying cause of the condition 2, 3, 4, 5, 6
- Initial management includes bladder drainage with urethral or suprapubic catheterization, which is the first line of treatment for acute urinary retention 2, 3, 6
- For chronic urinary retention, intermittent catheterization is often the most effective option 4, 5
- Other treatment options include:
- Conservative treatment, such as correcting likely causes and managing symptoms 4
- Drug therapy, such as alpha blockers, which may be started at the time of catheter insertion in some cases 3, 6
- Surgery, which may be necessary in some cases to correct underlying anatomical issues 3, 4
- Neuromodulation, which may result in prolonged relief for carefully chosen patients 5
- Urodynamic tests may be required in specific situations to determine the underlying cause of urinary retention and to guide treatment 4
- Follow-up is necessary to monitor response to treatment, detect complications, and manage symptoms 4