From the Guidelines
Urinary retention is defined as the inability to completely empty the bladder during urination, which can be assessed through repeated bladder scans or intermittent catheterizations in people with stroke who have incontinence or urinary retention. This condition is a significant concern in the context of stroke rehabilitation, as it can impact the quality of life and morbidity of patients 1. The assessment of urinary retention is crucial, and it involves evaluating the percentage of people with stroke who have incontinence or urinary retention and received an assessment of bladder residuals 1.
Key Points to Consider
- The definition of urinary retention is critical in the context of stroke rehabilitation, as it helps identify patients who require prompt assessment and intervention 1.
- The assessment of urinary retention involves repeated bladder scans or intermittent catheterizations, which can help determine the severity of the condition 1.
- The numerator for assessing urinary retention includes people with stroke who have urinary incontinence or retention and received an assessment for urinary retention, while the denominator includes people with stroke admitted to any facility for inpatient care who are incontinent or retaining urine 1.
Clinical Implications
- Early assessment and intervention are crucial to prevent complications associated with urinary retention, such as kidney damage or urinary tract infections.
- The management of urinary retention depends on the underlying cause, which may include catheterization, medications, or surgery to remove obstructions.
- It is essential to consider the exclusion criteria for assessing urinary retention, including people with stroke who have indwelling Foley catheters or other forms of nonphysiological bladder drainage, as well as those with normal spontaneous voiding without incontinence or retention 1.
From the Research
Definition of Urinary Retention
- Urinary retention is defined as the inability to void or achieve complete bladder emptying by voluntary micturition 2, 3, 4, 5.
- It can be categorized as acute urinary retention (AUR), chronic urinary retention (CUR), or incomplete bladder emptying 3.
- AUR is usually easy to identify and treat, while CUR is often more difficult to identify due to its asymptomatic nature 2.
Key Characteristics
- Urinary retention can be caused by a wide range of intrinsic and extrinsic, obstructive and non-obstructive factors affecting the lower urinary tract 2, 4.
- The condition can lead to serious complications, such as kidney damage or urosepsis, if left unidentified or untreated 2.
- Management of urinary retention depends on the underlying cause and may include conservative treatment, drug therapy, and surgery 2, 3, 4.
Diagnosis and Treatment
- Diagnosis of urinary retention typically involves a thorough history, physical examination, and selected diagnostic testing 4.
- Initial management includes bladder catheterization with prompt and complete decompression 4, 5.
- Alpha blockers have been shown to improve urinary symptoms and increase the success rates of trial without catheter in men with acute urinary retention 6.