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Retention

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Consultation in Neurourology

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Abstract

  • In neurological patients, retention may result from neurogenic detrusor underactivity (NDU) or detrusor-sphincter dyssynergia (DSD).

  • Comprehensive history and physical examination must be completed by means of a bladder/catheterization diary, questionnaires, urinalysis, urine culture, uroflowmetry, post-void residual measurement, urinary tract ultrasound, and other optional investigations. Urodynamic study is the cornerstone in the diagnosis, allowing clinicians to distinguish between NDU and DSD.

  • Treatment of retention aims to protect renal function and should involve intermittent catheterization or suprapubic catheter in all patients with a high post-void residual. Indwelling catheterization should be avoided, as it may lead to multiple complications.

  • Management also includes sacral neuromodulation, intrasphincteric injections of botulinum toxin A, and surgery. Nevertheless, currently available supportive data are sparse.

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    Jacques Corcos & Mikolaj Przydacz

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Corcos, J., Przydacz, M. (2018). Retention. In: Consultation in Neurourology. Springer, Cham. https://doi.org/10.1007/978-3-319-63910-9_8

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