What are the concerns for a patient with recent lithotripsy (extracorporeal shock wave lithotripsy) experiencing urinary retention?

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Differential Diagnosis for Urinary Retention after Lithotripsy

Single Most Likely Diagnosis

  • Ureteral obstruction due to stone fragments: This is the most likely cause of urinary retention after lithotripsy, as the procedure can sometimes cause stone fragments to obstruct the ureter, leading to urinary retention.

Other Likely Diagnoses

  • Hemorrhage or clot retention: Bleeding after lithotripsy can lead to clot formation, which may cause urinary retention.
  • Urethral stricture or trauma: The lithotripsy procedure itself or the insertion of instruments during the procedure can cause urethral trauma or stricture, leading to urinary retention.
  • Infection or sepsis: Infection after lithotripsy can cause inflammation and swelling, leading to urinary retention.

Do Not Miss Diagnoses

  • Sepsis due to obstructing stone: An obstructing stone can lead to infection and sepsis, which is a life-threatening condition if not promptly treated.
  • Retroperitoneal hemorrhage: Although rare, a retroperitoneal hemorrhage can occur after lithotripsy and is a potentially life-threatening condition that requires immediate attention.

Rare Diagnoses

  • Foley catheter malfunction: Although rare, a malfunctioning Foley catheter can cause urinary retention.
  • Spinal cord injury: In rare cases, lithotripsy can cause spinal cord injury, leading to neurogenic bladder and urinary retention.
  • Ureteral avulsion: This is a rare but serious complication of lithotripsy, where the ureter is torn, leading to urinary retention and other complications.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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