The Evaluation and Management of Acute Urinary Retention in Elderly Male patients

Abstract

Background: Urinary retention is a common urological
emergency characterized by sudden inability to pass urine
despite having a full bladder, which may or may not be
associated with abdominal pain.
Objective: The aim of this retrospective study is to document
the prevalence, risk factors, management and outcomes of
acute urinary retention in geriatric male patients.
Materials and Methods: Medical records of all patients who
had acute urinary retention treated at Urology Center Khost,
from January 2018 to April 2020 were retrospectively reviewed.
A total of 181 patients who had acute urinary retention were
included in this study. The demographic information, etiology
and treatment methods were collected and analyzed.
Results: The average age ranged from 47 to 89 years with
median age of 73. A total of 68 out of 181 patients presenting
with acute urinary retention were previously diagnosed with
BPH history of 1 year 15 patients (21%), 5 years 33 patients
(48%), >10 years 20 patients (31%). The rest of 113 patients
were categorized as having newly diagnosed BPH (54 cases)
48%, urethral stricture owing to STD (4 cases) 3.5%, history
of penile trauma (2 cases) 1.7%, occlusion due to urethral
and bladder stone (2 cases) 1.7%, bladder carcinoma (1
case) 1%, neurologic disorder (stroke, spinal cord lesion and
diabetic neuropathy) 62 cases (53%), neurogenic bladder 7
cases (6.2%). Urinary tract infection was exclusively found
in majority of the cases. Over all in 93% of the patients, the
symptoms resolved with successful bladder decompression
through urethral catheterization, 7% of the patients with difficult
catheterization, drainage was achieved by suprapubic bladder
catheterization under local anesthesia.
Conclusions: This study suggests that the incidence rate of
acute urinary retention is directly related to the efforts made
in primary prevention of acute urinary retention in high risk
patients. Acute urinary retention in BPH cases was more
evident in age group of ≥65 years. The most commonly used
initial management for acute urinary retention was by carrying
out bladder decompression via urethral catheterization, and
suprapubic catheter only being used in failures.