Rural Surgery pp 433-449 | Cite as

Urological Conditions

  • John Miller
  • Clair Whelan
  • Kulendran Sivapragasam


In all communities, metropolitan, rural or regional, urinary retention can be defined as acute or chronic and occurs in both sexes. Ultimately, evaluation and treatment by an urologist or uro-gynaecologists in some female cases is required. In most cases, the initial management after history and examination confirms urinary retention is placement of an indwelling urinary catheter. This chapter will discuss acute and chronic urinary retention in males, if seeking information regarding female urinary retention an excellent summary can be found in female urology (S. Razz). In all cases, male and female consultation and referral to an urologist should result in further evaluation and treatment within a short time frame.

Recommended Reading

Urinary Retention

  1. Ala-Opas, M.Y., Aitola, P.T., Metsola, T.E.J.: Evaluation of immediate and late results of transurethral resection of the prostate. Scand. J. Urol. Nephrol. 27, 235–239 (1993)PubMedCrossRefGoogle Scholar
  2. Ball, A.J., Feneley, R.C., Abrams, P.H.: The natural history of untreated “prostatism”. Br. J. Urol. 53, 613–616 (1981)PubMedCrossRefGoogle Scholar
  3. Emberton, M., Neal, D.E., Black, N., et al.: The national prostatectomy audit: the clinical management of patients during hospital admission. Br. J. Urol. 75, 301–316 (1995)PubMedCrossRefGoogle Scholar
  4. Emberton, M., Neal, D.E., Black, N., et al.: The effect of ­prostatectomy on symptom severity and quality of life. Br. J. Urol. 77, 233–247 (1996)PubMedCrossRefGoogle Scholar
  5. Estey, E.P., Mador, D.R., McPhee, M.S., et al.: A review of 1486 transurethral resections of the prostate in a teaching hospital. Can. J. Surg. 36, 37–40 (1993)PubMedGoogle Scholar
  6. Fuglsig, S., Aagaard, J., Jonler, M., et al.: Survival after transurethral resection of the prostate: a 10-year follow-up. J. Urol. 151, 637–639 (1994)PubMedGoogle Scholar
  7. Gibbons, R.P., Stark, R.A., Correa Jr., R.J., et al.: The prophylactic use—or misuse—of antibiotics in transurethral prostatectomy. J. Urol. 119, 381–383 (1978)PubMedGoogle Scholar
  8. Hindley, R.G., Mostafid, A.H., Brierly, R.D., et al.: The 2-year symptomatic and urodynamic results of a prospective randomized trial of interstitial radiofrequency therapy vs transurethral resection of the prostate. BJU Int. 88, 217–220 (2001)PubMedCrossRefGoogle Scholar
  9. Jacobsen, S.J., et al.: Natural history of prostatism: risk factors for acute urinary retention. J. Urol. 158, 481–487 (1997)PubMedCrossRefGoogle Scholar
  10. Kadow, C., Feneley, R.C., Abrams, P.H.: Prostatectomy or conservative management in the treatment of benign prostatic hypertrophy? Br. J. Urol. 61, 432–434 (1988)PubMedCrossRefGoogle Scholar
  11. McConnell, J.D., et al.: The effect of finasteride on the risk of acute urinary retention and the need for surgical treatment among men with benign prostatic hyperplasia. Finasteride long term efficacy and safety study group. N. Engl. J. Med. 338, 557–563 (1998)PubMedCrossRefGoogle Scholar
  12. McConnell, J.D., et al.: The long-term effects of doxazosin, finasteride and in combination on the clinical progression of benign prostatic hyperplasia. N. Engl. J. Med. 349, 2385–2396 (2003)CrossRefGoogle Scholar
  13. Mebust, W.K., Holtgrewe, H.L., Cockett, A.T.K., et al.: Transurethral prostatectomy: immediate and postoperative complications. A cooperative study of thirteen participating institutions evaluating 3,885 patients. J. Urol. 141, 243–247 (1989)PubMedGoogle Scholar
  14. Meigs, J.B., Barry, M.J., Giovannucci, E., et al.: Incidence rates and risk factors for acute urinary retention: the health professionals followup study. J. Urol. 162, 376–382 (1999)PubMedCrossRefGoogle Scholar
  15. Meigs, J.B., Mohr, B., Barry, M.J., et al.: Risk factors for clinical benign prostatic hyperplasia in a community-based population of healthy aging men. J. Clin. Epidemiol. 54, 935–944 (2001)PubMedCrossRefGoogle Scholar
  16. Melchior, J., Valk, W.L., Foret, J.D., et al.: Transurethral prostatectomy: computerised analysis of 2, 223 consecutive cases. J. Urol. 112, 634–642 (1974)PubMedGoogle Scholar
  17. Meyhoff, H.H., Nordling, J.: Long term results of transurethral and transvesical prostatectomy: a randomised study. Scand. J. Urol. Nephrol. 20, 27–33 (1986)PubMedCrossRefGoogle Scholar
  18. Roehrborn, C.G., Boyle, P., Bergner, D., et al.: Serum prostate-specific antigen and prostate volume predict long-term changes in symptoms and flow rate: results of a four-year, randomized trial comparing finasteride versus placebo. PLESS Study Group. Urology 54, 662–669 (1999a)PubMedCrossRefGoogle Scholar
  19. Roehrborn, C.G., McConnell, J.D., Lieber, M., et al.: Serum prostate specific antigen concentration is a powerful predictor of acute urinary retention and need for surgery in men with clinical benign prostatic hyperplasia. Urology 53, 473–480 (1999b)PubMedCrossRefGoogle Scholar
  20. Roehrborn, C.G., Bruskewitz, R., Nickel, G.C., et al.: Urinary retention in patients with BPH treated with finasteride or placebo over 4 years. Characterization of patients and ultimate outcomes. The PLESS Study Group. Eur. Urol. 37, 528–536 (2000a)PubMedCrossRefGoogle Scholar
  21. Roehrborn, C., Malice, M., Cook, T.J., Girman, C.J.: Clinical predictors of spontaneous acute urinary retention in men with LUTS and clinical BPH: a comprehensive analysis of the pooled placebo groups of several large clinical trials. Urology 58, 210–216 (2001)PubMedCrossRefGoogle Scholar
  22. Roos, N.P., Wennberg, J.E., Malenka, D.J., et al.: Mortality and reoperation after open and transurethral resection of the prostate for benign prostatic hyperplasia. N. Engl. J. Med. 320, 1120–1123 (1989)PubMedCrossRefGoogle Scholar

Surgically Sustained Injuries to the Urinary Tract

  1. Brandes, S., et al.: Consensus on genitourinary trauma diagnosis and management of ureteric injury: an evidence based analysis. BJU Int. 84, 277–288 (2004)CrossRefGoogle Scholar
  2. Peng, M.Y., Parisky, Y.R., Cornwell, E.E., et al.: CT cystography versus conventional cystography in evaluation of bladder injury. AJR Am. J. Roentgenol. 173, 1269–1272 (1999)PubMedGoogle Scholar
  3. Preston, J.M.: Iatrogenic ureteric injuries: common medico-legal pitfalls. BJU Int. 86, 313–317 (2000)PubMedCrossRefGoogle Scholar

Open Nephrectomy

  1. Burgess, N.A., Koo, B.C., Calvert, R.C., et al.: Randomized trial of laparoscopic v open nephrectomy. J. Endourol. 21, 610–613 (2007)PubMedCrossRefGoogle Scholar
  2. Gill, I.S., Matin, S.F., Desai, M.M., et al.: Comparative analysis of laparoscopic versus open partial nephrectomy for renal tumours in 200 patients. J. Urol. 170, 64–68 (2003)PubMedCrossRefGoogle Scholar
  3. Joudi, F.N., Allareddy, V., et al.: Analysis of complications ­following partial and total nephrectomy for renal cancer in a population based sample. J. Urol. 177, 1709–1714 (2007)PubMedCrossRefGoogle Scholar
  4. McKiernan, J., Simmons, R., et al.: Natural history of chronic renal insufficiency after partial and radical nephrectomy. Urology 59, 816–820 (2002)PubMedCrossRefGoogle Scholar
  5. Patard, J.J., Shvarts, O., Lam, J.S., et al.: Safety and efficacy of partial nephrectomy for all T1 tumours based on an international multicenter experience. J. Urol. 171(pt 1), 2181–2185 (2004)PubMedCrossRefGoogle Scholar
  6. Shekarriz, B., Upadhyay, J., Shekarriz, H., et al.: Comparison of costs and complications of radical and partial nephrectomy for treatment of localized renal cell carcinoma. Urology 59, 211–215 (2002)PubMedCrossRefGoogle Scholar
  7. Shuford, M.D., McDougall, E.M., Chang, S.S., et al.: Complications of contemporary radical nephrectomy: comparison of open vs laparoscopic approach. Urol. Oncol. 22, 121–126 (2004)PubMedCrossRefGoogle Scholar
  8. Simforoosh, N., Basiri, A., et al.: Comparison of laparoscopic and open donor nephrectomy; a randomized controlled trial. BJU Int. 95, 851–855 (2005)PubMedCrossRefGoogle Scholar
  9. Stephenson, A.J., Hakimi, A.A., et al.: Complications of radical and partial nephrectomy in a large contemporary cohort. J. Urol. 171, 130–135 (2004)PubMedCrossRefGoogle Scholar
  10. Van Poppel, H., Pozzo, D.A., et al.: A prospective randomized EORTC intergroup phase 3 study comparing the complications of elective nephron sparing surgery and radical nephrectomy for low-Stage renal cell carcinoma. Eur. Urol. 51, 1606–1615 (2007)PubMedCrossRefGoogle Scholar

Further Reading

  1. Blaivas, J.G., Weiss, J.P. (eds.): Benign prostatic hyperplasia and lower urinary tract symptoms. Urol. Clin. North Am. 36(4),  W.B. Saunders, Philadelphia (2009)Google Scholar
  2. Ras, S.: Female Urology, 2nd edn. W.B. Saunders, Philadelphia (1996)Google Scholar
  3. Wein, A.J., Kavoussi, L.R., Novick, A.C., Partin, A.W., Peters, C.A.: Campbell – Walsh Urology, 9th edn. Saunders Elsevier, Philadelphia (2007)Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2011

Authors and Affiliations

  • John Miller
    • 1
  • Clair Whelan
    • 1
  • Kulendran Sivapragasam
    • 1
  1. 1.Department of SurgeryThe Queen Elizabeth HospitalWoodville SouthAustralia

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