Abstract
DESCRIPTIVE STUDY OF ACUTE URINARY RETENTION IN A TERTIARY CARE CENTRE OF CENTRAL SRI LANKA

Anurudda Udaya Bandara Pethiyagoda*, Inaam Niyas, Dulanjalee Lakmini Keeragala, Narasin Vidana Gamage Himali Erandika, Osura Rojith Amarajeewa, Lashan Chathuranga Silva and Sithara Nilmini Warnasooriya

ABSTRACT

Introduction: Acute Urinary Retention (AUR) is a common, painful condition mainly affecting men above 60 years of age. Objectives: Detailed description of AUR in terms of demographics, risk factors, presentation, clinical examination, and management. Method: A retrospective analysis of 101 patients with AUR over 4 years. Results: Mean age was 64.79 years, most in the 61–70-year age (35.6%). Most were males (91.1%) enrolled in elementary occupations (56.06%). However, association of AUR with occupation cannot be commented upon due to disproportionate utilization of public health services by lower socio-economic classes. Smoking and alcohol consumption were significantly higher among males. Most (56.4%) had a long history of Lower Urinary Tract Symptoms (LUTS) prior to AUR (Median = 180 days), however only 42.1% of them received prior treatment. Men, and those who have not received treatment for LUTS tend to present earlier with AUR. Most had precipitated AUR (62.4%) due to a single precipitating factor (77.8%). Constipation (42.9%) and delay in micturition (41.3%) were the most common precipitants. Most AUR was successfully treated with simple urethral catheterization with a minority (5.9%) requiring suprapubic catheterization. The median residual volume was 850ml. In most patients, prostate was moderately enlarged (55.43%) and of firm consistency (82.2%), bladder could be palpated / percussed (87.1%), hernial orifices were intact (92.1%), external genitalia normal (92.1%), and no neurological abnormality (91%). Conclusion: AUR is a disease of elderly males, commonly precipitated by constipation or delay in micturition. Treatment of LUTS may delay / prevent onset of AUR.

Keywords: Acute Retention, Benign Prostatic Hyperplasia, AUR, LUTS, Residual volume, Urinary Catheterization.


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