Retention

  • Jacques Corcos
  • Mikolaj Przydacz
Chapter

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.

Keywords

Retention Neurogenic detrusor underactivity Detrusor-sphincter dyssynergia Intermittent catheterization Clean intermittent catheterization Sterile intermittent catheterization Indwelling catheterization Suprapubic tube Sacral neuromodulation Intrasphincteric injections of botulinum toxin A External sphincterotomy 

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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Jacques Corcos
    • 1
  • Mikolaj Przydacz
    • 1
  1. 1.Department of UrologyJewish General Hospital, McGill UniversityMontrealCanada

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