Acute urinary retention in the first and second-trimester of pregnancy:Three case reports

BACKGROUND Acute urinary retention(AUR)is rare during pregnancy.CASE SUMMARY We report on three pregnant women with AUR between the 10^(th) and 18^(th) wk of gestation.Case 1 was first diagnosed as urinary tract infection and developed a urinary tract infection due to urinary retention caused by urethral obstruction.Case 2 had a history of previous abdominal surgery for pelvic tuberculosis,leading to severe adhesions and a persistent retroverted uterus.In case 3,healthcare providers focused on the patient’s gastrointestinal symptoms and did not investigate her inability to void.Case 1 required manual disimpaction of the uterus and the knee-chest position.The other cases required immediate catheterization.The condition resolved in cases 1 and 2;these patients had normal pregnancies.Case 3 had severe complications at the time of consultation,leading to an abortion.CONCLUSION Retroverted uterus is the most common cause of AUR.Prompt recognition and diagnosis are required.Clinicians should be aware of the risk factors,etiology,and clinical presentation of AUR in the first and second trimester of pregnancy.

Prostate artery embolization for the treatment of urinary retention caused by large(>80 mL) benign prostatic hyperplasia: Results of 21 patients

Objective:A large prostate size(>80 m L)of benign prostatic hyperplasia(BPH)is technically challenging to treat surgically.This study aimed to investigate the safety and efficacy of super-selective prostatic artery embolization(PAE)for the treatment of urinary retention caused by large BPH.Methods:A total of 21 patients with urinary retention,indwelling urinary catheter,or suprapubic cystostomy as a consequence of giant BPH(prostate volume[PV]>80 mL)who sought treatment between January 2013 and December 2017 were enrolled.A microcatheter(1.9–2.7 Fr)and a"two-step embolization"combining 50-μm and100-μm polyvinyl alcohol embolization particles were used in all patients.International Prostate Symptom Score(IPSS),quality of life(QoL),PV,and prostate-specific antigen(PSA)were evaluated at 3,6,and 12 months postPAE.Clinical success was defined as removal of urinary catheter or suprapubic cystostomy and ability to void spontaneously.Results:The clinical success rate was 95.2%(20/21).Compared with pre-procedural values,IPSS,QoL,PV,and PSA showed statistically significant differences at 3,6,and 12 months post-PAE(P<0.05).There were no serious complications after PAE.Conclusions:PAE was safe and effective for the treatment of urinary retention caused by large BPH in patients without surgical treatment options.

Mechanism of"Five Meridians Acupuncture"in Treating Postoperative Urinary Retention after Anorectal Diseases

In recent years,with the change of rhythm and eating habits of the public,the number of patients with anorectal diseases has gradually increased,and postoperative urinary retention has also become more common.Urinary retention refers to the symptoms of anorectal diseases and is caused by improper urination and incompletion of urination due to surgical and pain causes that result in bladder and urine filling and are accompanied by lower abdominal distention and pain.In traditional Chinese medicine,acupuncture is simple and effective as a treatment.In this article,we focus on five meridians that pass through the lower abdomen Ren meridian,kidney meridian,spleen meridian,stomach meridian,and liver meridian,namely the"five meridians,"and study the mechanism of action so as to provide new therapeutic ideas for clinical acupuncture treatment of postoperative urinary retention of anorectal diseases.

A rare cause of acute urinary retention-Primary malignant melanoma of prostate

Acute urinary retention is commonly seen in elderly male patient due to benign enlargement of prostate.We report a 65-year-old male presenting with acute urinary retention diagnosed to have primary malignant melanoma of prostate.Primary malignant melanoma of genitourinary tract is very uncommon diagnosis in urology and prostate involvement is extremely rare.Till now only five cases have been reported.

Penile Metastasis of Colorectal Cancer Mimicking Priapism with Acute Urinary Retention: A Rare Case

Background: Penile metastasis of colorectal carcinoma is a rare phenomenon in clinical setting. They normally manifest as penile lesion and acute urinary retention. However, presentation of priapism is exceedingly rare. Aims: Discussion of this rare presentation as well as the diagnostic processes and subsequent management. Case Presentation: A 54-year-old male with a history of colorectal cancer presents with acute urinary retention. Examination of the patient demonstrates a semi-erect penis, with multiple palpable nodules on the shaft and penile meatus. Histological and imaging findings indicate penile metastasis of colorectal cancer. Conclusion: Biopsy via cystoscopy is used to obtain definitive diagnosis of penile metastasis. Urinary drainage followed by further cancer intervention or palliative care is crucial for effective management.

Primary Presentation of Ovarian Cancer with Bladder Outlet Obstruction/Chronic Urinary Retention in a 12-Year Old Female

Urinary retention in women is rare and is more frequently described as case reports or small case series. The female/male ratio is 1:13 with about 3 cases per 100,000 women every year We report a case of a 12-year old female student. She presented with progressive weight loss, worsening lower urinary tract symptoms with distended lower abdomen of 10 weeks duration. Physical examination revealed a mobile tender firm pelvic mass, 18 centimeters (cm) × 16 cm in size. Laboratory and imaging studies showed obstructive nephropathy and uropathy respectively. She was worked up and had uneventful exploratory laparotomy with right salpingo-oophorectomy, urinary bladder diverticulectomy and pelvic lymphadenectomy. Histopathology of the pelvic mass showed ovarian dysgerminoma with lymph node metastasis. She responded very well to chemotherapy and resumed her school activities. Bladder outlet obstruction is relatively rare in females and in the index patient, ovarian dysgerminoma is the cause leading to obstructive nephropathy and uropathy.

A study of acupoint selection rules of moxibustion and auricular point therapy in the treatment of urinary retention after anorectal surgery based on data mining

Based on the Traditional Chinese Medicine Inheritance Support System(V2.5),we explored the compatibility rules of moxibustion and auricular point prescriptions in the treatment of urinary retention after anorectal surgery,and further to obtain new prescriptions.Methods:We searched CNKI,Wanfang,VIP and CBM databases for the literature of moxibustion and auricular point therapy for urinary retention after anorectal surgery,collecting complete prescriptions and entering them into the Traditional Chinese Medicine Inheritance Support System(V2.5).The acupoint frequency,association rules,and combination rules were analyzed by data mining method of software integration.Results:126 moxibustion prescriptions were selected,and the acupoints for urinary retention after anorectal surgery in the literature were analyzed,including 10 acupoints with frequency≥6,9 acupoint combinations with frequency≥26,5 acupoints with association rules,6 core acupoint combinations and 3 new prescription.124 auricular point prescriptions were selected,and the relevant acupoints in the literature were analyzed,including 10 acupoints with frequency of use≥18,15 acupoint combinations with frequency≥40,12 acupoint combinations with association rules,6 core acupoint combinations,and 3 new prescriptions.The core points include Qihai(RN6),Sanyinjiao(SP6),Zhongji(RN3),Guanyuan(RN4).The auricular point therapy is more to select the tenderness points and acupoints that have an impact on the urinary system,mainly including“Pangguang”(CO9),“Shenmen”(TF4),“Shen”(CO10),“Sanjiao”(CO17),“Pizhixia”(AT4),“Niaodao”(HX3),“Fei”(CO14),“Jiaogan”(AH6a).Conclusion:Moxibustion for the treatment of urinary retention is mainly based on invigorating“Primordial Qi”and regulating the functions of“Middle Jiao”(refers to the area of the body just below the diaphragm and above the navel that helps produce delicate nutrients).The entropic clustering of complex systems excavated new prescriptions for the treatment of urinary retention after anorectal surgery,providing new ideas for future research and treatment.

Urinary Retention in Adults Male Patients: Causes and Complications among Patients Managed in a Teaching Hospital in North Western Nigeria

Background: Urinary retention is one of the common urologic emergencies constituting a significant workload of urologists and non-urologists alike. Aims and Objectives: This study was undertaken to identify the causes and complications associated with urinary retention in adult male patients at AKTH, Kano. Patients and Methods: It was a prospective hospital-based study of 110 consecutive adult male patients who presented to Aminu Kano Teaching Hospital, Kano with urinary retention over 12 months. On presentation, a brief history was taken and rapid physical examination done;the urinary retention was relieved by urethral catheterization or suprapubic cystostomy. A detailed history and thorough physical examination findings were later obtained. Results: One hundred and ten patients were seen during the study period. There ages ranged from 17 to100 years with a mean of 56 ± 19.3 SD years. Patients within the age range 55 - 74 years accounted for the largest group, (25.5% + 23.6% = 49.1%). The most common cause of urinary retention in this study was benign prostatic hyperplasia (51.8% of the patients). This was followed by urethral stricture (20%), cancer of the prostate (7.3%), urethral injury (7.3%) and bladder tumour (6.4%). More than half of the patients (53.4%) presented with acute urinary retention, 30.5% presented with chronic urinary retention, and 16.1% were diagnosed to have acute-on-chronic urinary retention. The complications of urinary retention found were: urinary tract infection (in 24.5% of patients), renal impairment (14.5%), and anaemia (11.8%). Conclusion: Urinary retention is commoner among the middle aged and the elderly. Benign prostatic hyperplasia remains the leading cause of urinary retention. Acute urinary retention was the commonest type of urinary retention;however, complications due to the retention were associated with chronic and acute-on-chronic urinary retention.

Acupuncture at Xinbaliao Point in Treating A Case of Urinary Retention after Rectal Cancer Surgery

Urinary retention after surgery is caused by inadvertent damage to the muscles and nerves around the bladder during the operation,which results in the suppression of the urination reflex,or the postoperative pain that causes sphincter spasm and dysuria.It is a common complication after anorectal disease,with an incidence rate of up to 52%,which seriously affects the daily life of patients.It has been clinically discovered that acupuncture at Xinbaliao point can effectively improve urinary retention,relieve swelling in the lower abdomen,and improve the quality of life of patients.In this report,we present a case of postoperative urinary retention that had been treated with acupuncture at the Xinbaliao point.

Glanular Anterior Urethral Valve;A Case Report of an Unusual Cause of Neonatal Urinary Retention

Anterior urethral valve is an uncommon abnormality whose etiology is uncertain, unlike in the case of posterior urethral valve. Glanular anterior urethral valve is even rarer. We present an unusual case of anterior urethral valve, which presented with acute urinary retention and was successfully managed with excision and glans reconstruction. A history of poor stream and dribbling, recurrent urinary tract infections and palpable penile or peno-scrotal mass strongly points to the diagnosis of anterior urethral valve. A voiding cystourethrogramme confirms the diagnosis. It can cause early proximal urinary tract damage and renal failure if not intervened in time. Early surgical intervention will prevent the onset of uremia. Transurethral resection is the treatment of choice.

Study on the Application Effect of Flexible Nursing Care in Patients with Postpartum Urinary Retention and its Effect on Lactation

Objective: To study the application effect of flexible nursing in patients with postpartum urinary retention and its effect on lactation. Methods: A total of 200 cases of postpartum urinary retention patients admitted between January 2021 and January 2022 were selected and randomly grouped into two groups, a control group (conventional nursing) and an observation group (flexible nursing), of 100 cases each. The time of onset of lactation, the lactation volume score, urinary indicators, the amount of post-partum hemorrhage, and the quality of life score of the two groups were compared. Results: The observation group’s lactation initiation time (21.41 ± 1.52) h and lactation volume score (2.11 ± 0.52) were better than that of the control group (P < 0.05). The observation group’s first urination time (2.11 ± 0.51) min was lower than the control group, while the urinary retention completely relieved time (33.12 ± 8.61) h, and first urinary volume (262.17 ± 52.41) mL was higher than that of the control group (P < 0.05). The amount of postpartum hemorrhage in the observation group (151.21 ± 22.12) mL was less than that in the control group (P < 0.05). The scores of somatic functioning (86.25 ± 2.20), psychological functioning (91.56 ± 1.45), social functioning (89.25 ± 2.45), and material life (89.75 ± 1.45) of the observation group were higher than those of the control group after nursing (P < 0.05). Conclusion: Flexible nursing care in patients with postpartum urinary retention exhibited significant nursing effects and lactation function was effectively improved.

High Urine Retention: Experience in a Series of Patients with Renal Failure Patients

Purpose: High urinary retention (HUR) can negatively impact renal function. Our study aimed to present the epidemiological, diagnostic, and therapeutic aspects of HUR in a Senegalese academic hospital. Patients and Methods: We conducted a retrospective study of 70 patients with HUR associated with renal failure from January 2017 to December 2020. Parameters examined included: age, sex, coexisting conditions affecting renal function, clinical symptoms, diagnostic tests, causes of HUR, urinary diversion, and patient outcomes. Results: The average age was 66, with a majority of male patients (87%). Twenty-three patients had pre-existing medical conditions. Oligo-anuria was the most common reason for detecting HUR (70%). Half of the patients had an ECOG score ≥ 2. The mean creatinine level was 50.7 mg/l. Nineteen patients exhibited hydroelectrolytic disorders. Bacterial colonization was observed in 25 patients. Ultrasound and computed tomography were the most frequently performed imaging tests (100% and 62.8%, respectively). Sixty-seven patients had ureterohydronephrosis (UHN), with bilateral UHN in 88.6% of cases. Pelvic cancers (47.1%) were the primary cause of HUR, primarily bladder cancers (27.1%). Nephrostomy was the most common urinary drainage method (50%), particularly for obstructions due to pelvic cancer (88.6%). The majority of patients (52.8%) regained normal renal function after drainage. Nineteen deaths occurred among elderly patients with compromised general health. Conclusion: Urinary drainage significantly improved renal function for most patients. Pelvic cancer emerged as the leading cause of HUR. Nephrostomy was the predominant drainage method.

Clinical Observation on the Acupuncture Treatment in Patients with Urinary Retention after Radical Hysterectomy

Objective： To observe the acupuncture therapy effect on the urinary retention after radical hysterectomy. Methods： Eighty cases of urinary retention after radical hysterectomy were randomly assigned to the treatment group and control group according to the random number table method, 40 cases in each group. From the 15th day post operation, the patients in the two groups started to be treated and 7 days as a course with 5 days treatment and 2 days interval. The treatment group applied acupuncture with modalities of common needling on Zusanli （ST36） bilaterally, electroacupuncture on Sanyinjiao （SP6）, Shuidao （ST28）, and Scalp Reproduction Area bilaterally, moxibustion on Shenque （CV8）. The control group applied acupoint injection with vitamin B12, and Sanyinjiao and Zusanli were selected. Take turns on both sides. The courses for the recovery of bladder function and residual urine volume for those who had voluntary micturition more than 200 ml. after the first and second course of treatment were compared between the two groups. Results： Within 1 course and 2 courses of treatment, the patients with bladder function recovery in the treatment group were 21 （21/40） and 36 （36/40）, and those in the control group were 12 （12/40） and 29 （29/40）, both with a significant difference （P〈0.05）. After the first course and second course, residual urine volume for those who had voluntary micturition more than 200 mL in the treatment group was 91.7＋ 17.5 mL and 93.5＋ 15.5 mL, in the control group 102.4＋ 13.7 mL and 102.5 ＋ 15.7 mL, both with a significant difference （P〈0.05）. Conclusions： Combination of acupuncture modalities was better than acupoint injection for the recovery of bladder function in urinary retention after radical hysterectomy. It would shorten the course of treatment and get a better recovery, decrease urinary retention cases of refractoriness, and extending the treatment could raise the healing rate of urinary retention.

The effect of immediate surgical bipolar plasmakinetic transurethral resection of the prostate on prostatic hyperplasia with acute urinary retention

In the present study, we evaluated the safety and efficacy of immediate surgical bipolar plasmakinetic transurethral resection of the prostate （PK-TURP） for patients with benign prostatic hyperplasia （BPH） with acute urinary retention （AUR）. We conducted a retrospective analysis of clinical data of BPH patients who received PK-TURP. A total of 1126 BPH patients were divided into AUR （n = 348） and non-AUR groups （n = 778）. After the urethral catheters were removed, the urine white blood cell （WBC） count in the AUR group significantly increased compared with the non-AUR group （P〈 0.01）. However, there was no significant difference in international prostate symptom score, painful urination, and maximal urinary flow rate. The duration of hospitalization of the AUR group was longer than that of the non-AUR group （P 〈 0.001）. A total of 87.1% （303/348） patients in the AUR group and 84.1% （654/778） patients in the non-AUR group completed all of the postoperative follow-up visits. The incidence of urinary tract infection in the AUR group within 3 months after surgery was significantly higher than that in the non-AUR group （P 〈 0.01）. The incidence of temporary urinary incontinence in the AUR group did not exhibit significant difference. During 3-12 months after surgery, there were no significant differences in major complications between the two groups. Multivariate regression analyses showed that age, postvoid residual, maximal urinary flow rate, diabetes, and hypertension, but not the presence of AUR, were independent predictors of IPSS post-PK-TURP. In conclusion, immediate PK-TURP surgery on patients accompanied by AUR was safe and effective.

Bethanechol Remains the Preferred Drug in Suspected Underactive Bladder: Findings from Nation-Wide Prescription Analysis

Background: Bethanechol chloride, a cholinergic agonist, is often prescribed in suspected underactive bladders to improve detrusor contractility, despite its limited clinical efficacy. We investigated the usage pattern of bethanechol in actual practice with the understanding that it would enable the physicians to make an informed decision on the coherent use of bethanechol. Methods: A nation-wide survey was carried out to obtain the responses of the urologists. Out of the 755 urologists approached, 630 survey responses were considered for analysis. Results: Usage of bethanechol was advocated as very common [318 (50.48%)], common [200 (31.75%)], not so common [107 (16.98%)], and rare [5 (0.79%)] in postoperative urinary retention, where it was preferred either exclusively [255 (40.48%)] or along with alpha blockers [247 (39.21%)]. Predilection to use alpha-blocker [247 (39.21%)], alpha-blocker plus naloxone [4 (0.64%)], naloxone [1 (0.16%)], alpha-blocker plus bethanechol plus naloxone [1 (0.16%)] was also observed. It was also preferred individually in pathologies causing urinary retention such as benign prostatic hyperplasia [125 (19.84%)], diabetic neuropathy [82 (13.02%)], neurological diseases [69 (10.95%)], senile bladder [14 (2.22%)], drugs [13 (2.06%)], and infective/inflammatory conditions [6 (0.95%)]. Other [321 (50.95%)] physicians opted to prescribe bethanechol in two or more of the enumerated indications. Bethanechol was prescribed orally as 25 mg thrice daily [441 (70.00%)], 50 mg thrice daily [86 (13.65%)], 25 mg four times daily [59 (9.37%)], and many “strongly agree” and “agree” that its sustained release formulation may offer better treatment compliance [565 (89.68%)], safety [548 (86.99%)], and efficacy [544 (86.35%)]. Conclusion: Bethanechol was the most prescribed drug for the management of postoperative urinary retention and other pathologies suspected to cause underactive bladder.

Urological Emergencies at the University Hospital of Brazzaville: Epidemiological, Clinical, and Therapeutic Aspects

Introduction: Urological emergencies play a significant role in the medical and surgical activity of a urology department. The objective of this study was to determine the hospital prevalence of urological emergencies at the University Hospital of Brazzaville (CHUB), identify the different pathologies requiring urgent care, and list the various therapeutic methods. Patients and methods: A retrospective study of patients admitted to the medical and surgical emergencies department of CHUB over a 5-year period. Patient records admitted and treated for a urological emergency were included. The variables studied were the frequency of urological emergencies, patient age at admission, gender, nature of the emergency, and various therapeutic options. Results: Urological emergencies accounted for 4.3% of all medical and surgical emergencies. The mean age was 57 ± 28 years with a range of 3 to 93 years. The male-to-female ratio was 7.1. The most common conditions were urinary retention (54.67%), hematuria (17.20%), and renal colic (8.13%). Therapeutically, surgical urinary drainage was dominated by cystostomy. Conclusion: Urological emergencies are infrequent at the University Hospital of Brazzaville. Their management is often delayed.

Clinical study of prevention of urine retention after subabdominal surgery by electro-acupuncture acupoints Yin Ling Quan(SP 9),Zhao Hai(KI 6) with the assistance of subarachnoid acupoint anesthesia

OBJECTIVE:To explore the prevention of urine retention after subabdominal surgery by electro-acupuncture Yin Ling Quan(SP 9),Zhao Hai(KI 6) acupoints with the assistance of subarachnoid acupoint anesthesia by observing the postoperative voiding time and urine volume of postoperative patients undergoing Electroacupuncture plus subarachnoid block anesthesia.METHODS:60 cases of preoperative expected for subarachnoid block surgery patients were randomly divided into two groups,the treatment group and the control group,with 30 cases in each group.The control group underwent routine subarachnoid anesthesia after surgery without acupuncture treatment group;The treatment group was treated with acupuncture bilateral Yin Ling Quan and Zhaohai acupoints 15 minutes before anesthesia,and then received unilateral electric anesthesia instrument treatment,the intensity of the patient was tolerable(generally 1.5 ~ 2.0 m A),and the routine subarachnoid block anesthesia was performed;The first urination time,urine volume,lower abdominal pain and assistant catheterization were recorded in the two groups.RESULTS:The first postoperative voiding time of the treatment group was significantly earlier compared with that of the control group,there was significant difference(P<0.05);the amount of urine was significantly more than that of the control group in reservation time,there was significant difference(P<0.05);the abdominal pain was light in the treatment group,there was significant difference(P<0.05);the cases of assisted catheterization of the control group were significantly more thanthose of the treatment group,there was significant difference(P< 0.05).CONCLUSION:Electro-acupuncture Yin Ling Quan(SP 9),Zhao Hai(KI 6) acupoints with the assistance of subarachnoid acupoint anesthesia could significantly reduce the urine retention after subabdominal surgery in postoperative patients with ubarachnoid block anesthesiau,accelerate the recovery of bladder function and promote early postoperative urination in addition to relieving the abdominal symptoms after operation.

Operating procedures of moxibustion technology

Moxibustion therapy is a treatment and health-care method that originated from China.It is a kind of therapy for preventing and treating diseases by stimulating meridians and acupoints using heat to regulate the viscera and enhance immunity.This article introduces the definition and mechanism of moxibustion technology,clinical operation technics,and precautions of moxibustion in practice,and demonstrates plenty of iconic cases of application of moxibustion in the treatment of insomnia,dysmenorrhea,urinary retention,knee arthritis,chronic eczema,etc.,so as to provide a reference for the wide application of moxibustion technology.

Suprapubic Cystostomy at Urological Emergency Unit of CHU-YO, Ouagadougou, Burkina Faso: Indications, Technique and Complications

Introduction: Cystostomy allows under certain circumstances deriving the urine. This is the most performed surgery in uro-andrological emergencies. Complications can occur. We aim to analyze the indications, technical aspects and complications of suprapubic cystostomies in the urological emergency unit at CHU-YO. Patients and Methods: Between October 2013 and May 2014 we conducted a prospective study of all patients who underwent suprapubic cystostomy. Results: 86 cases of cystostomy were noted or 77.5% of surgical procedures performed in uro-andrological emergency. All patients were male. The average age of patients was 52.5 years. The AUR represented 88.4% of indications. The prostate tumor represented 65.8% of the etiologies of AUR. The cystostomy was performed under local anesthesia in 87.2% of cases. Peritoneal gap was noted in 5.8%, parietal suppuration in 12.8%. A death by generalized acute peritonitis was noted in one case. Conclusion: Suprapubic cystostomy presents a non-negligible morbidity and mortality and must be mastered.

Nearly-complete labial adhesions diagnosed with repetitive cystitis in postmenopausal women:A case report

BACKGROUND Nearly-complete labial adhesions diagnosed with repetitive cystitis in postmenopausal women:A case report CASE SUMMARY The case of an 83-year-old woman who presented with dysuria,urination disorders,recurrent cystitis,and bacteriuria and was admitted to a private hospital after 1 mo of antibiotic treatment without improvement of her symptoms.Upon examination,labial adhesions were observed with nearly-complete labial fusion with a pinpoint opening.Bacteriuria was detected in urine analysis,and the urine culture test was positive for Escherichia coli.Therefore,a parenteral antibiotic(Fosfomycin)and topical estrogen cream were administered.However,since the adhesion did not separate after 2 wk of treatment,surgical correction was performed.First,adhesiolysis was conducted with a blunt instrument.Then,hysteroscopy and cystoscopy were performed.Hysteroscopic findings showed no abnormalities of the endometrium and endocervix,and the cystoscopic results were also normal.Finally,labiaplasty was completed to prevent adhesion recurrence.One month after the surgery,the discomfort while urinating was eliminated and the adhesion did not recur.CONCLUSION Labial adhesions in postmenopausal women cannot be successfully treated with estrogen creams,and surgical treatment should be considered.