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Submitted by: Steven Guptha
Urinary retention is also known as ischuria.
Defination:
It is lack of ability to urinate.
It is a common complication of benign prostatic hypertrophy (also known as benign prostatic hyperplasia or BPH).
Retention of urine can be acute or chronic.
Acute urinary retention:
Even though bladder is full a person with this condition cannot urinate at all.
Acute urinary retention is a medical emergency requiring prompt action.
Chronic urinary retention:
With chronic urinary retention, person may be able to urinate, but you have trouble starting a stream or emptying your bladder completely.
Person may urinate frequently or may feel an urgent need to urinate but have little success when get to the toilet or may feel that still have to go after finishing urinating.
Chronic urinary retention may not seem life threatening, but it can lead to serious problems and should also receive attention from a health professional.
Incidence:
Urinary retention is a common disorder in elderly males as the most common cause of urinary retention is benign prostate hypertrophy .
And this disorder starts around age 50 and symptoms may appear after 10-15 years.
BPH is a progressive disorder and narrows the neck of the bladder leading to urinary retention.
In young males, the most common cause of urinary retention is infection of the prostate (Acute prostatitis).
Causes:
In the bladder:
a.Neurogenic bladder
b.Iatrogenic scarring of the bladder neck (commonly from removal of indwelling catheters)
c.Damage to the bladder
d.bladder stones
In the prostate:
a.Prostate cancer
b.Benign prostate hyperplasia
c.Prostatitis
Others
a.infections
b.surgeries
c.medications
d.spinal cord injury
e.constipation
f.uretheral stricture
g.cystocele and rectocele
Symptoms:
Acute urinary retention causes
a.great discomfort, and even pain.
b.Person feel an urgent need to urinate but simply cant.
c.The lower belly is bloated.
Chronic urinary retentioncauses
a.mild but constant discomfort.
b.difficulty starting a stream of urine.
c.Once started, the flow is weak.
d. need to go frequently.
e. dribbling of urine between trips to the toilet because bladder is constantly full, a condition called overflow incontinence.
Diagnosis:
1.History of Complaints and Physical Examination
2.Urine Sample:
A urine sample will be examined for signs of infection, which may be a cause or a result of urinary retention.
3.Bladder Scan
4.Cystoscopy
5.X Ray and Computerized Tomography (CT) Scan
6.Blood Test for Prostate-specific Antigen (PSA) for prostate cancer
7.Prostate Fluid Sample for prostatis
8.Urodynamic Tests:
Urodynamic tests include different techniques to measure the bladders ability to empty steadily and completely.
Treatment:
1.Catheterization:
With acute urinary retention, treatment begins with the insertion of a catheter through the urethra to drain the bladder.
This initial treatment relieves the immediate distress of a full bladder and prevents permanent bladder damage.
2.Treatments to Relieve Prostate Enlargement
3.Surgery for Women with Cystocele or Rectocele
4.Treatments for Men with Urethral Stricture
Complications:
1.Urinary Tract Infection
2.Bladder Damage
3.Chronic Kidney Disease
Homoeopathic treatment:
1.Equisetum:
a.dull distressing pain
b.a feeling of fullness in the bladder, even after urinating, this remedy may be helpful.
c.Urging and discomfort are more intense when the bladder has recently been emptied,
2.Apis mellifica:
This remedy is indicated when the person:
a.frequently needs to urinate, but only small quantities are passed.
b.Stinging and burning sensations are felt
c.Heat and touch make the symptoms worse, and cold applications, cool bathing, and open air bring relief.
d.A lack of thirst is another indication.
3. Belladonna:
This remedy may be beneficial:
a.if urging to urinate is frequent and intense, and the bladder feels very sensitive.
b.A cramping sensation may be felt in the bladder area.
c.Small amounts of highly-colored urine pass(useful even if passes small amounts of blood)
About the Author: Dr Guptha faculty for the
medical billing training
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