Female Urinary Retention

Excerpt

Urinary retention is one of the most prevalent urological complaints resulting in patients presenting to the emergency department, although this is typically in men rather than women. It is loosely defined as the inability to pass urine, but a more precise definition is a bit challenging. The best consensus-recommended definition is a complete inability to void spontaneously or persistently elevated post-void residual urine volumes, which would lead to an adverse clinical outcome without any intervention.

Typically, the diagnosis is made from the finding of a high post-void residual urine volume, often along with symptoms of suprapubic pain or inability to void. Post-void residual urine volume measurements are typically made by using a bladder scanner or ultrasound to estimate the amount of urine remaining in the bladder after urination or by straight catheterization. Patients with acute retention will typically complain of suprapubic pain and inability to void normally, but some patients, particularly the elderly, may be asymptomatic. The normal maximum bladder capacity is about 500 mL, so any amount over this is clearly abnormal and suggestive of urinary retention.

The condition is vital as it can lead to significant clinical problems if left untreated, such as bladder decompensation, hydronephrosis, renal failure, vesicoureteral reflux, nephrolithiasis, and urinary tract infections, as well as symptoms including suprapubic pain, feelings of incomplete emptying, weak urinary stream, urgency, and incontinence.