Low-friction, hydrophilic-coated catheters increased patient satisfaction and decreased urinary tract infection and hematuria in patients with neurogenic bladder who practice clean, intermittent self-catheterization.īenign prostatic hyperplasia meatal stenosis paraphimosis penile constricting bands phimosis prostate cancer Suprapubic catheters improve patient comfort and decrease bacteriuria and recatheterization in patients requiring catheterization for up to 14 days.
Silver alloy-impregnated urethral catheters reduce the incidence of urinary tract infections in hospitalized patients requiring catheterization for up to 14 days. Prevention of acute urinary retention in men with benign prostatic hyperplasia may be achieved by long-term treatment with 5-alpha reductase inhibitors.
OVERFLOW INCONTINENCE NEUROGENIC TRIAL
Men with urinary retention from benign prostatic hyperplasia should undergo at least one trial of voiding without catheter before surgical intervention is considered. In men with benign prostatic hyperplasia, initiation of treatment with alpha blockers at the time of catheter insertion improves the success rate of trial of voiding without catheter. Definitive management of urinary retention will depend on the etiology and may include surgical and medical treatments. Patients with chronic urinary retention from neurogenic bladder should be able to manage their condition with clean, intermittent self-catheterization low-friction catheters have shown benefit in these patients.
Suprapubic catheterization may be superior to urethral catheterization for short-term management and silver alloy-impregnated urethral catheters have been shown to reduce urinary tract infection. Men with acute urinary retention from benign prostatic hyperplasia have an increased chance of returning to normal voiding if alpha blockers are started at the time of catheter insertion. Initial management includes bladder catheterization with prompt and complete decompression. A thorough history, physical examination, and selected diagnostic testing should determine the cause of urinary retention in most cases. Obstructive causes in women often involve the pelvic organs. Other common causes include prostatitis, cystitis, urethritis, and vulvovaginitis receiving medications in the anticholinergic and alpha-adrenergic agonist classes and cortical, spinal, or peripheral nerve lesions. The most common cause of urinary retention is benign prostatic hyperplasia. Causes of urinary retention are numerous and can be classified as obstructive, infectious and inflammatory, pharmacologic, neurologic, or other. Urinary retention is the inability to voluntarily void urine.
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