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  • Urinary Retension: Prof. Dr. Dr. H. Rifki Muslim, SPB, Spu

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    Anita Mayasari
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    This document discusses urinary retention, which is the inability to empty the bladder. It can be partial or total. The main causes are mechanical issues, neurological problems, problems with the detrusor muscle that contracts the bladder, psychological stress, and certain drugs. A history and physical exam are important for diagnosis, looking for signs of bladder distension, pain, and inability to void. Initial treatments involve catheterization, suprapubic puncture, or cystostomy to drain the bladder, along with identifying and addressing the underlying cause. Further tests like imaging may be needed to diagnose the specific cause.

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    This document discusses urinary retention, which is the inability to empty the bladder. It can be partial or total. The main causes are mechanical issues, neurological problems, problems with the detrusor muscle that contracts the bladder, psychological stress, and certain drugs. A history and physical exam are important for diagnosis, looking for signs of bladder distension, pain, and inability to void. Initial treatments involve catheterization, suprapubic puncture, or cystostomy to drain the bladder, along with identifying and addressing the underlying cause. Further tests like imaging may be needed to diagnose the specific cause.

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    26 views10 pages

    Urinary Retension: Prof. Dr. Dr. H. Rifki Muslim, SPB, Spu

    Uploaded by

    Anita Mayasari
    This document discusses urinary retention, which is the inability to empty the bladder. It can be partial or total. The main causes are mechanical issues, neurological problems, problems with the detrusor muscle that contracts the bladder, psychological stress, and certain drugs. A history and physical exam are important for diagnosis, looking for signs of bladder distension, pain, and inability to void. Initial treatments involve catheterization, suprapubic puncture, or cystostomy to drain the bladder, along with identifying and addressing the underlying cause. Further tests like imaging may be needed to diagnose the specific cause.

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    Download as PPT, PDF, TXT or read online from Scribd
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    of 10

    URINARY RETENSION

    Prof. DR. Dr. H. Rifki Muslim, SpB, SpU


    Retention :- Partial DD : - Oliguria
    - Total - Anuria

    Emergency case in urologi

    History :
    Can not void well
    Straining disuria
    Frequency (polakisuria) nocturia
    Sense of residual urine
    Suprapubic pain
    History og etiologi

    Physical examination :
    a. Suprapubic : pain, bulging, perssure
    pain.
    b. External genitalia.
    c. DRE (digital rectal examination)

    Cause :
    1. Mechanic
    2. Neurogenic
    3. Myogenic
    4. Psychogenic
    5. Drugs

    Mechanical Cause

    1. Baby / Children
    Phymosis/paraphimosis
    Agenesis urethra
    Stenosis of external meatus
    Inflamation of glans penis
    Stone
    Tumor
    Bladder neck sclerotic
    Posterior urethral valve

    2. Adult :
    Phymosis/paraphimosis
    Urethral stricture
    Meatal stenosis
    Urethritis
    Gravid
    Stone
    Tumor
    Bladder neck sclerotic

    3. Old :
    Neoplasma prostatse benign
    Malignant
    Urethral stricture
    Meatal stenosis
    Vesicocele
    Urethritis
    Caruncule of urethra
    Stone
    Tumor
    Bladder neck sclerotic

    Neurogenic retention :
    Disorder of S2-4 med.spin (caused
    by truma / tumor)
    Diabetic neuropathy

    Myogenic retention :
    Disorde of detrussor muscle - trauma
    Over distention

    Psychogenic retention
    Psychical stress (woman)

    Retention caused by drug:
    Sulfas atropin
    Hyociamine sulfate
    Propantheline bromide (probanthine)
    L-epinephrine
    Ephedrine
    Phenilephrine
    Imipramine Hcl (tofranil)
    Beta blocker (propanolol etc)

    Diagnostics :
    1. Hystory of illness
    2. Physical examination :
    a. Suprapubic region :
    Inspection : bulging
    Palpation : pressure pain
    Percussion : pain, dullness
    Auscultation : neg
    b. External genitalia
    c. DRE
    d. BCR
    e. Instrumentation

    Treatment :
    1. Catheterization
    2. Suprapubic puncture
    3. Cystostomy
    4. Stop drugs
    5. Definitive treatment

    Further diagnostic :
    1. Plain photo & IVU
    2. Retrograde urethro cystography
    3. USG
    4. Uretrhro cyctography

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