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

Background: Urinary retention is a common urologicalemergency characterized by sudden inability to pass urinedespite having a full bladder, which may or may not beassociated with abdominal pain.Objective: The aim of this retrospective study is to documentthe prevalence, risk factors, management and outcomes ofacute urinary retention in geriatric male patients.Materials and Methods: Medical records of all patients whohad 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 wereincluded in this study. The demographic information, etiologyand treatment methods were collected and analyzed.Results: The average age ranged from 47 to 89 years withmedian age of 73. A total of 68 out of 181 patients presentingwith acute urinary retention were previously diagnosed withBPH history of 1 year 15 patients (21%), 5 years 33 patients(48%), >10 years 20 patients (31%). The rest of 113 patientswere categorized as having newly diagnosed BPH (54 cases)48%, urethral stricture owing to STD (4 cases) 3.5%, historyof penile trauma (2 cases) 1.7%, occlusion due to urethraland bladder stone (2 cases) 1.7%, bladder carcinoma (1case) 1%, neurologic disorder (stroke, spinal cord lesion anddiabetic neuropathy) 62 cases (53%), neurogenic bladder 7cases (6.2%). Urinary tract infection was exclusively foundin majority of the cases. Over all in 93% of the patients, thesymptoms resolved with successful bladder decompressionthrough urethral catheterization, 7% of the patients with difficultcatheterization, drainage was achieved by suprapubic bladdercatheterization under local anesthesia.Conclusions: This study suggests that the incidence rate ofacute urinary retention is directly related to the efforts madein primary prevention of acute urinary retention in high riskpatients. Acute urinary retention in BPH cases was moreevident in age group of ≥65 years. The most commonly usedinitial management for acute urinary retention was by carryingout bladder decompression via urethral catheterization, andsuprapubic catheter only being used in failures.