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Etiologies of urinary retention in women
Source publication
The management of urinary retention in the elderly female can present a challenging conundrum for primary care physicians, geriatricians, and urologists. It is often difficult to diagnose due to concomitant comorbidities and potential cognitive impairments. Evaluation should include a comprehensive history and physical examination, post-void residu...
Context in source publication
Context 1
... acute urinary retention is by definition always problematic, elevated post-void residual may be asymp- tomatic or associated with debilitating problems such as recurrent infection or urinary incontinence. Furthermore, urinary retention can be caused by a variety of disease processes, which in general are associated with either anatomic outlet obstruction or bladder dysfunction (Table 1) [3,4]. ...
Citations
... While bladder outlet obstruction (BOO) is relatively common among older male patients, the etiology of urinary retention in women encompasses a broader spectrum of conditions, complicating epidemiological research and understanding of underlying pathophysiology [14] . Available data on the incidence of AUR in women are limited, although a Scandinavian study reported an incidence rate of 7 per 100,000 population per year, with a significant male predominance [12,13] .However Female urinary retention is widely recognized as being significantly underestimated and often goes undiagnosed [15] . ...
The occurrence of acute urinary retention (AUR) in females is relatively infrequent, yet it is noteworthy when observed as a manifestation of acute appendicitis in an otherwise healthy middle-aged woman. Presented herein is the case of a 58-year-old woman who experienced an inability to void urine for 10 hours, accompanied by mild pain initially noted in the suprapubic region and subsequently shifting to the right iliac fossa. Upon admission, the patient exhibited afebrile status and hemodynamic stability. Physical examination revealed a mild tenderness in the lower abdominal region, alongside a palpable bladder situated midway between the symphysis pubis and umbilicus. Bowel sounds were found to be within normal. Laboratory investigations indicated elevated inflammatory markers, and urinanalysis disclosed the presence of moderate amount of pus cells. Ultrasonography revealed acute appendicitis with a fecolith obstructing the base of the appendix. This case underscores the challenge faced by surgeons in recognizing the atypical presentation of acute appendicitis and underscores the importance of thorough and repeated abdominal examinations to achieve diagnostic precision.
... The incidence of urinary retention is higher in men than in women and increases with age. (5) It is estimated 3 to 7 cases per 100,000 women yearly, with the female-to-male ratio is 1 : 13. (6) POD is a clinical diagnosis based on urine output after decompression of urinary tract obstruction. (4) Our patient met the definition for post-obstructive diuresis with 3500 ml of urine output over 24 hours after the release of obstruction. ...
... With the acts such as the Human Rights Act 37 , the Constitutional Reform Act 38 , the European Union (herein referred to as EU) referendum in 2016, House of Lords Reform Act 39 , House of Lords (Expulsion and Suspension) Act 40 , EU (Withdrawal) Act 41 Act 42 the discussion on whether Britain should adopt a written Constitution has been a significant topic of conversation 43 . The process of Brexit has caused a crisis 44 in relation to the unwritten constitution and left it in a molten condition as stated by Andrew Blick and Peter Hennessy 45 . ...
... The medical management for chronic urinary retention which includes HPCR and low pressure chronic urinary retention (LPCR) is more complex and highly individualized with renal functions, urodynamic studies, and patients' concerns. Malik et. al., (2014) suggested that management of these patients with HPCR would depend on detailed history and physical examination, urodynamic investigations that are decided on individual basis. Yenli et al (2015) and Mevcha & Drake (2010) explain that, intermittent or indwelling catheterization is indicated for abnormal renal functions or lower urinary ...
... urine full report, culture, and oral antibiotics. A study done by Cochran (2007) mentioned that the duration to keep catheter for long-term is for thirty days continuously or more and the most common complications on long-term catheterization included bacteriuria, encrustation, blockage, stones, urethral erosions, hematuria and fistula formation. Malik et. al. (2014) further states that the goals for optimal care of chronic urinary retention should be included symptom reduction, prevention of urinary tract infections, and avoidance of upper urinary tract deterioration. Also, Mevcha & Drake (2010) emphasized the follow-up care, which is essential for monitoring the responses to treatment, complicatio ...
The majority of contemporary research has focused on the cosmetic application in fresh plant materials but there is a lack of critical analyses on the potential of plant waste material for the cosmetic industry. In this regard, this study was conducted with aid the literature from the 2000-2022 period. Accordingly, we can conclude that the nonedible plant materials such as seeds and peels and food wastes contain a significant number of phytochemicals which are the key ingredient of natural cosmetic products, and low-cost as well as non-toxic ingredients for cosmetic products. But using food waste can be challenging since plants are biodegradable, before using for cosmetics it should be tested for any microorganism activity which can affect the skin as well. Then availability and collection of waste such as soaked water, seeds, and peels will be difficult since first of all it has to be consumed in the food used in the cosmetic industry. However, the analysis result of the phytochemical content of plant waste has shown a significant value in the cosmetic industry due to their anti-inflammatory activity, antioxidant activity, anti-tyrosinase, and elastase activity for the skin.
... Acute onset of urinary retention in older women during hospitalization correlates with physical function, ambulatory ability, and mortality [1,2]. The main causes of urinary retention in women during hospitalization are anatomical outlet obstruction and bladder dysfunction, associated with neurological disease, infection, drugs, and pain affecting dysuria [3]. There is also evidence of urinary retention being associated with polypharmacy and frailty [3,4]. ...
... The main causes of urinary retention in women during hospitalization are anatomical outlet obstruction and bladder dysfunction, associated with neurological disease, infection, drugs, and pain affecting dysuria [3]. There is also evidence of urinary retention being associated with polypharmacy and frailty [3,4]. However, in 20%-30% of cases of acute urinary retention that develops during hospitalization, the underlying cause is unknown [5]. ...
Acute urinary retention during hospitalization is a poor prognostic predictor. Therefore, prevention of the same is important. Herein, we describe two cases of acute urinary retention in older women admitted to the hospital for acute illness, with severe sarcopenia being the only predisposing cause. Both women developed urinary problems shortly after admission. In both, acute urinary retention was preceded by an in-hospital period of poor nutritional intake and a lack of progress in rehabilitation. There was no evidence of genitourinary disorder, neurological disease, drug-induced dysuria, bone fracture, or pain. Both patients presented with severe sarcopenia and severe frailty.Although the loss of mass in the voiding muscles is difficult to detect, the possibility of dysuria as one of the complications of acute and severe sarcopenia was indicated in our patients. Of note, however, is that many patients with severe sarcopenia do not develop dysuria. Therefore, accumulating evidence on the possible association between severe sarcopenia and dysuria is needed to inform prevention.
... 5 Conservative efforts may also be undertaken by withdrawing offending medications, treating constipation or other precipitating causes of urinary retention, and engaging in pelvic floor rehabilitation. 4 If there are mild consequences of the CUR (i.e., recurrent UTIs) then a trial of alphablockers, aimed to relax the urethra muscles, may be started. 3 A systematic review and metaanalysis on the use of alpha-blockers in women with CUR showed improvement in symptoms (International Prostate Symptom Score (IPSS) mean difference -1.5 (95%CI -2.91 to -0.09)) but no difference in PVR 9 . ...
... 9 There is limited evidence for cholinergic monotherapy (i.e., bethanechol). 4 One double blinded randomized controlled trial showed a moderate CUAJ -Residents' Room Landells et al Case: Chronic urinary retention in elderly women 3 © 2022 Canadian Urological Association reduction in PVR and increase in flow rate but was limited by its small sample size. 10 A separate small study reported that bethanechol did not improve voiding efficiency better than placebo. ...
... However, there is very little data in the literature that describes CISC in older adults. Voiding dysfunction is common in this population, with different possible mechanisms [2][3][4] and complications such as urinary tract infections and overflow incontinence. ...
Aims
The primary aim is to explore the adherence predicting factors in clean intermittent self‐catheterization (CISC) in patients aged over 65 years. The secondary aim is to assess whether in this population, the non‐adherence risk is greater, compared with patients under 65.
Methods
All patients older than 65 that successfully learned CISC between January 2011 and January 2016 were included. A control population younger than 65 matched with sex, body mass index, and pathology was selected.
Results
One hundered and thirteen (66.9%) out of the 169 patients older than 65 included were adherent at 1 month, and 80 (47.3%) at 6‐12 months. Obesity (P = 0.027), a low PP test (Pencil and Paper test) score (P = 0.037), significant urinary stress incontinence (SUI) (P = 0.048), and prescription of CISC less than three per day (P = 0.03) were the risk factors predicting stopping CISC at 1 month, but none was associated with non‐adherence at 6‐12 months.
Compared with the younger group, age was a risk factor for poor adherence at 1 month.
Conclusion
Obesity, low PP test score, and important SUI are factors of poor adherence to CISC at 1 month in older adults. Necessity of more than three CISC per day is in favor of treatment continuation, possibly due to absence of spontaneous voiding in these patients. Long‐term adherence to CISC in older adults in this study remains close to adherence to other treatments prescribed in urinary disorders, and thus shows that CISC could be an easily purposed therapeutic option in this population, either on a long‐term or transitory basis.
... Therefore, from a total of 1,927 articles identified in the databases, 31 were considered relevant to answering the research question (Ablove, 2010;Abrams et al., 2002;Arianyagam, Arianyagam, & Rashid, 2011;J. Buchanan, & M. Beckmann, 2014;Chang, 2014;Chang, Hsieh, & Yang, 2012;Chapple & Osman, 2015;Gursoy et al., 2015;Hansen, Soreid, Darland, & Nilsen, 2011;Haylen et al., 2010;Hernandez et al., 2013;Huang et al., 2011;Johansson & Christensson, 2010;Justo, Schwartz, Dvorkin, Gringauz, & Groutz, 2016;Madersbacher et al., 2012;Mago et al., 2010;Malik, Cohn, & Bales, 2014;Maserejian et al., 2011;Mulder et al., 2012;Mulder et al., 2014;Negro & Muir, 2012;Nevo, Mano, Livne, Sivan, & Ben-Meir, 2014;Oelke, Speakman, Desgrandchamps, & Mamoulaks, 2015;Osman et al., 2014;Saaby & Lose, 2012;Shimoni, Fruger, & Froom, 2015;Silveira et al., 2015;Wilson, 2015). Several additional sources were included in this integrative review: an English language dictionary (Deuter, Bradbery, & Turnbull, 2016), a publication by the ICS (Abrams et al., 2002), and a book published by ICS in 2013 (Staskin et al., 2013). ...
... The diagnostic label itself, "urinary retention," which was used in the literature search as a synonym for "absence of urinary elimination," is differentiated into acute and chronic urinary retention by many authors (Abrams et al., 2002;Haylen et al., 2010;Hernandez et al., 2013;Linton et al, 2013, Malik, Cohn, & Bales, 2014Negro & Muir, 2012;Oelke et al., 2015;Staskin et al., 2013;Wilson, 2015). This differentiation clarifies the elements that make up the phenomenon, facilitating diagnostic inferences and guiding management of the event. ...
Purpose:
To develop conceptual and operational definitions for defining characteristics and related factors for nursing diagnosis of urinary retention, as contained in Taxonomy II of NANDA-I.
Data sources:
Integrative literature review and elaboration of terms related to urinary retention.
Data synthesis:
It includes operational and conceptual definitions of the nursing diagnosis urinary retention.
Conclusions:
It is necessary to review the definition of this nursing diagnosis and most of its defining characteristics and related factors.
Implications for nursing practice:
The use of internationally known terms for various disciplines in areas of common knowledge helps to standardize the language used by professionals.
... Thus, vulvovaginal atrophy, sexual dysfunctions, urine retention, urinary incontinence (UI), renal dysfunctions, and urinary infections are common among post-menopausal women. [1][2][3][4][5][6][7][8][9] Moreover, genitourinary dysfunctions worsen the quality of life of women. 10,11 Post-menopausal women also have a high prevalence of clinical and subclinical hypothyroidism. ...
... Thus, ageing seems to be the most important factor for urinary alterations. 6,7 Our present findings also show that having an age of ≥65 years and a moderate-to-high normal concentration of TSH is harmful for some quality of life components associated with physical energy. In agreement, low-to-normal levels of TSH are associated with a high resting energy expenditure, 39 indigenous of México, and has a low income, low educational level, and nutritional deficiency. ...
The present study was aimed to investigate the relationship between normal serum concentrations of thyrotropin (TSH) and urinary incontinence (IU), urinary infections, and quality of life in old women. Euthyroid post-menopausal women without sarcopenia, estrogen replacement, emotional illness, and-or cancer were enrolled as participants. Anthropometric indicators, serum glucose and estradiol, and thyroid profile were measured. Sociodemographic, clinical, physical activity, and quality of life (SF-36) surveys were applied. One-hour pad test and International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) were used to determine UI. Urinalysis was also done. In agreement with results from the pad test (cut-off point ≥ 1.4 g), the ICIQ-SF reveled ~50% of incontinent women. A high percentage of women had moderate-high bacteriuria and urinary infections. Logistic regression analysis showed that age is a risk factor for both UI and urinary infection. Nor diabetes, number of pregnancies or childbirths, urinary infections, and bacteriuria influenced in the presence of UI. To allocate women into four groups according to their age (<65 or ≥65 years old) and TSH concentrations (0.3-1.9 or 2-10 μUI/mL), we found that moderate-to-high normal levels of TSH is a risk factor for UI and a worst quality of life in the oldest women. Our results highlight the profit of measuring TSH concentrations in post-menopausal women. This article is protected by copyright. All rights reserved.
... However, there is very little data in the literature that describes CISC in older adults. Voiding dysfunction is common in this population, with different possible mechanisms [2][3][4] and complications such as urinary tract infections and overflow incontinence. ...
Objective
Investigate failure prediction in learning self-catheterization for patients over 65 and evaluate whether this population is more liable to fail as compared to younger patients.
Materials/patients and methods
All patients over 65 who had come to learn self-catheterization between January 2011 and January 2016, regardless of their pathology, were included, with a retrospective collection of data (pathology, scores of disability and success or failure of the catheterization learning). A control population of subjects under 65 was matched based on gender, pathology and BMI (Body Mass Index) criteria.
Results
Two hundred and two patients over 65 years with an average 73.7 years of age were included. 140 patients (69%) had neurological voiding dysfunction. One hundred and sixty nine patients (83.7%) managed to learn intermittent self-catheterization. A BMI over 30 kg/m² was associated with learning failure (p = 0.0186). The patients who failed had a FIM (Functional Independence Measure) (p = 0.0039) and a PP test (Pencil and Paper Test) (p = 0.0085) lower than the group who succeded learning. High age was not associated with learning failure. No significant differences by gender or pathology were made obvious, and no significant difference in the ability to self-catheterize properly was revealed as compared to younger subjects either.
Discussion/Conclusion
If two studies [1,2] had previously evaluated adherence to self-catheterization according to age with conflicting results, none assessed intermittent learning gesture. A BMI > 30 kg/m² is an unfavorable factor for the acquisition of gesture, as a PP low test and a low MIF. On the other hand, age, gender, pathology or cognitive disorders should not therefore contraindicate self-catheterization for the elderly, in case of a medical treatment indication.
... Chronic urinary retention (CUR) is a common urological problem that greatly impacts patients' general health, quality of daily life [32], psychological states [32], and social contact. Prestudies reveal that acupuncture may have promising therapeutic effectiveness in urinary retention [31,33]. ...
... Chronic urinary retention (CUR) is a common urological problem that greatly impacts patients' general health, quality of daily life [32], psychological states [32], and social contact. Prestudies reveal that acupuncture may have promising therapeutic effectiveness in urinary retention [31,33]. ...
... In addition, CUR due to SCI can greatly impact patients' health-related quality of life (HRQL) [32] and the improvement of HRQL can also be an important outcome for the effectiveness. Moreover, SF-36 and other internationally accepted scoring scales can help evaluate the patients' general health, which can be applied to measure the HRQL. ...
No systematic review has been published on the use of acupuncture for the treatment of chronic urinary retention (CUR) due to spinal cord injury (SCI). The aim of this review was to assess the effectiveness and safety of acupuncture for CUR due to SCI. Three randomized controlled trials (RCTs) including 334 patients with CUR due to SCI were included. Meta-analysis showed that acupuncture plus rehabilitation training was much better than rehabilitation training alone in decreasing postvoid residual (PVR) urine volume (MD −109.44, 95% CI −156.53 to −62.35). Likewise, a combination of acupuncture and aseptic intermittent catheterization was better than aseptic intermittent catheterization alone in improving response rates (RR 1.23, 95% CI 1.10 to 1.38). No severe adverse events were reported. In conclusion, acupuncture as a complementary therapy may have a potential effect in CUR due to SCI in decreasing PVR and improving bladder voiding. Additionally, acupuncture may be safe in treating CUR caused by SCI. However, due to the lack of high quality RCTs, we could not draw any definitive conclusions. More well-designed RCTs are needed to provide strong evidence.
