Obstruction of urinary tract anywhere below the bladder, causing distension and incomplete emptying of the bladder. It can be acute (Acute Urinary Retention) or chronic.
Causes
- BPH/ prostate cancer
- Bladder tumors, stones
- Pelvic masses (rarely pregnancy)
- Rarely neurological causes
- Infections can precipitate acute retention
- Chronic obstruction can cause hydronephrosis and chronic kidney damage
Clinical features
- Acute: painful and tender pelvic mass, difficulty in passing urine
- Chronic: obstructive and irritative symptoms (see BPH), painless pelvic mass
Investigations
- Urine analysis, C&S
- Abdominal ultrasound
- Renal function tests
- Other specialised investigations (Cystourethrogram)
Management
- Urethral catheter to relieve obstruction (≥ 18 F)
- Suprapubic catheter if urethral fails
- Treat infection if present
- Refer to specialist for assessment/care