Doctors Lounge - Urology Answers
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Forum Name: Urology Topics
Question: urine retention
|friendsfan - Fri Oct 30, 2009 2:13 pm||
Im a 27 y/o female.
I have been catheterized several times over the last few week, due to retention. by the continence nurse.
Im now in retention, should I visit A+E or just let it be, as i usually do, I will just pass small amounts like 50mls, Im quite distended at the min, but its not too painful yet.
|Dr.M.Aroon kamath - Thu Nov 12, 2009 12:21 am||
From your profile, i gather that you had undergone 'right and left knee tibial tubercle transfers' in the past (exactly when and for what indication is not clear).The indication for urinary retention is also unclear.
The prime indications for tibial tubercle transfer are said to be
- 2 or more complete patellar dislocations with trivial trauma or
- recurrent subluxations with or without pain causing "giving way." of the knee joint.
Was your urinary retention in any way related to a fall?
The reason why i am raising these questions is to try and determine which type bladder dysfunction you may be suffering from(The 'autonomous' bladder or the 'automatic' / Reflex bladder).
Assuming that you probably have an 'autonomous' neurogenic bladder, the following protocol may help you to understand the basis behind intermittent catheterizations...
The bladder is usually drained on a regular basis, either based on a timed interval (ex, on awakening, then every 3-6 hours during the day, and before retiring to bed) or based on bladder volume.
One should remember that the average adult urinary bladder holds approximately 400-500 mls of urine. Ideally, the amount drained each time should not exceed 400-500 mL.
This drainage limit may be titrated by decreasing the fluid intake or by increasing the frequency of catheterizations. For example,if catheterization is performed every 6 hours and the amount drained is 800 mls, then one should increase the frequency of catheterization to, perhaps, every 4 hours to maintain the volume drained at 400-500 mL.
Intermittent catheterization is designed to simulate normal voiding and to prevent over-distension of the urinary bladder. Usually, an average adult empties the bladder 4-5 times a day. Thus, catheterization should occur 4-5 times a day; however, individual catheterization schedules may vary, depending on the amount of fluid taken in during the day.
I hope this information may help to clarify some of your doubts.
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