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.

The risk factors of postpartum urinary retention after vaginal delivery:A systematic review

Objectives:This review aimed to explore the independent risk factors of postpartum urinary retention(PUR)after a vaginal delivery.Methods:The Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)was followed and relevant studies were retrieved from eleven databases.The quality of the included articles was assessed using Critical Appraisal Skills Programme tools or the Appraisal tool for Cross-Sectional Studies.The data analysis was performed using Review Manager version 5.3.Results:A total of nine articles were included and five risk factors were identified,namely,episiotomy(OR=2.99,95%CI=1.31e6.79,P=0.009),epidural analgesia(OR=2.48,95%CI=1.09e5.68,P=0.03),primiparity(OR=2.17,95%CI=1.06e4.46,P=0.03),instrumental delivery(OR=4.01,95%CI=1.97 e8.18,P<0.001),and the duration of the second stage of labor(MD=15.24,95%CI=11.20e19.28,P<0.001).However,fetal birth weights of more than 3800 g were not identified as an independent risk factor(MD=64.41,95%CI=-12.59 to 141.41,P=0.10).Conclusion:This systematic review indicated that the independent risk factors for PUR were found to include episiotomy,epidural analgesia,instrumental delivery,primiparity,and a longer second stage of labor.In clinical practice,healthcare providers could pay more attention to women with these factors and prevent postpartum urinary retention.

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.

Meta-analysis of neostigmine injections given at the Zusanli （ST 36） acupoint in thetreatment of postpartum urinary retention

Objective： We aimed to determine the effect of neostigmine injections given at the Zusanli （ST 36） acupoint whentreating postpartum urinary retention. Methods： We conducted a systematic review to identify randomized controlledtrials （RCTs） involving neostigmine injections given at the Zusanli （ST 36） acupoint for treating postpartum urinaryretention. We searched the Cochrane Library, Pubmed, Web of Science, Chinese National Knowledge Infrastructure, VipDatabase, and Chinese Biomedical Literature Database from the creation of the database to December 30, 2016. Bias riskassessment was performed using Revman 5.3 software from Cochrane based on the criteria set out in the CochraneHandbook for Systematic Reviews of Interventions, version 5.1.0. Results： Thirteen studies were included with 627participants in the treatment group and 584 participants in the control group. （1） Overall response rate： neostigmineinjections given at the Zusanli （ST 36） acupoint have a better curative effect than injections given in muscle, odds ratio（OR） = 8.74, 95% confidence interval （CI） [5.83, 13.10], Z = 10.49 （P 〈 0.001）; （2） Comparison of effects at differentdosages： （i） 0.5 mg of neostigmine Zusanli （ST 36） acupoint injection group has better effect than 1 mg of neostigmineintramuscular injection group, OR = 15.84, 95% CI [5.74, 43.72],Z = 5.34 （P 〈 0.001）, （ii） 0.5 mg of neostigmineinjection given at the Zusanli acupoint has a better curative effect than 0.5 mg of neostigmine injection given in muscle ,OR = 7.30, 95% CI [3.47, 15.34], Z = 5.24 （P 〈 0.001）; （iii） 1 mg of neostigmine injection at the Zusanli （ST 36）acupoint has better efficacy than 1 mg of neostigmine injection in muscle, OR = 7.76, 95% CI [4.46, 13.52], Z = 7.25 （P〈 0.001）. Conclusion： Neostigmine injections at the Zusanli （ST 36） acupoint have beneficial effects in treatingpostpartum urinary retention. However, the low quality of the studies included in the meta-analysis raises questions overthe reliability of the results. Further studies are still needed.

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.

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.

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.

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.

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.

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.

Remodeling of motor cortex function in acute cerebral infarction patients following human urinary kallidinogenase A functional magnetic resonance imaging evaluation after 6 months

A total of 29 patients were treated within 48 hours after acute subcortical cerebral infarction with Xuesaitong or Xuesaitong plus human urinary kallidinogenase for 14 days. Neurological deficits, activity of daily living, and evaluations of distal upper limb motor functions at the 6-month follow-up showed that patients treated with Xuesaitong plus human urinary kallidinogenase recovered better than with Xuesaitong alone. In addition, functional MRI revealed that activation sites were primarily at the ipsilesional side of injury in all patients. Human urinary kallidinogenase induced hyperactivation of the ipsilesional primary sensorimotor cortex, premotor cortex, supplementary motor area, and contralesional posterior parietal cortex. Results showed that human urinary kallidinogenase improved symptoms of neurological deficiency by enhancing remodeling of long-term cortical motor function in patients with acute cerebral infarction.

A case of acute urinary retention after cesarean section caused by herpes zoster infection

We experienced a case of acute urinary retention after an elective cesarean section. In this case, an epidural catheter was inserted for the postoperative pain relief, and we had to rule out anesthetic complications including epidural hematoma. After careful investigation, sacral herpes zoster was found to be responsible for urinary retention. Early administration of antiviral agent was started and the outcome was good. As various factors may lead to postpartum urinary disorders, we should be careful not to miss serious complications.

Post-operative urinary retention: Review of literature

Postoperative urinary retention(POUR) is one of the postoperative complications which is often underestimated and often gets missed and causes lot of discomfort to the patient. POUR is essentially the inability to void despite a full bladder in the postoperative period. The reported incidence varies for the wide range of 5%-70%. Multiple factors and etiology have been reported for occurrence of POUR and these depend on the type of anaesthesia, type and duration of surgery,underlying comorbidities, and drugs used in perioperative period. Untreated POUR can lead to significant morbidities such as prolongation of the hospital stay, urinary tract infection, detrusor muscle dysfunction, delirium, cardiac arrhythmias etc. This has led to an increasing focus on early detection of POUR.This review of literature aims at understanding the normal physiology of micturition, POUR and its predisposing factors, complications, diagnosis and management with special emphasis on the role of ultrasound in POUR.

Very Low, Real-Time Rate of Urinary Retention after Intradetrusor Botox^&regfor Non-Neurogenic Overactive Bladder

Introduction: According to the most recent AUA/SUFU guidelines, intradetrusor onabotulinumtoxinA (BTN/A) is a standard, evidence strength grade B, third line treatment option for refractory non-neurogenic overactive bladder (OAB). Urinary retention is the most common clinically significant reported side effect ranging from 5.4% to 43% in previous studies. The aim of this study was to investigate the real-time rate of urinary retention in patients treated with BTN/A for refractory non-neurogenic OAB in a multi-institutional study. Methods: Retrospective chart review identified 71 patients who were treated with 100U BTN/A for refractory non-neurogenic OAB from August 2011 to July 2015 at two institutions. Using a flexible cystoscope, 100U Botox&reg reconstituted with 10 ml normal saline was administered. Injections of 1 ml (10 units/ mL) were administered in 10 evenly distributed sites sparing the trigone. Pre and post BTN/A post-void residuals (PVR) were reviewed. Urinary retention was defined as PVR > 200 mL requiring clean intermittent catheterization (CIC). Results: After exclusion, the study group consisted of 66 patients with a mean age of 67 years and 30% were men. Mean pre and post-procedural PVR were 14.06 mL and 69.21 mL. Eight patients (12.12%) were noted to have elevated PVR > 200 mL post injection however only one patient (female) required initiation of CIC. The rate of urinary retention was 1.5% (N = 1). There was no correlation with age, history of previous radiation, diabetes or prior use of a neuromodulator device. Conclusions: To the best of our knowledge, this is the first study to demonstrate a very low risk of real-time urinary retention rates in appropriately selected patients treated with BTN/A for refractory non-neurogenic OAB outside of a clinical trial setting.

Acute Urinary Retention among Adult Men at Bobo-Dioulasso University Teaching Hospital: Epidemiology, Aetiologies and Initial Management

We conducted a cross-sectional study between February 1st, 2012 and September 30, 2012 at Bobo-Dioulasso University Teaching hospital. The target population was all patients seen at the emergency services for acute urinary retention. Among the 155 patients admitted for urological emergencies, 104 (67.1%) had acute urinary retention. The average age of patients was 65 years, ranging from 23 to 89 years and the majority was more than 60 years old (77.8%) and lived in rural areas (64.4%). Prostate tumor pathology and urethral stricture were the most frequent diagnosis, and the renal function was impaired in 33.7% of cases. Urethrovesical drainage, cystocatheterism, and suprapubic cystostomy were the treatment approach in 56.0%, 28.0% and 15.2% of the cases. Acute urinary retention is the most common urological emergency and many complications are associated with urethrovesical sounding. These complications should therefore be prevented by improving acute urinary care.

A Feasibility Study of an Individualized Voiding Program in Japan to Improve the Sense of Control in Older People with Functional Urinary Incontinence

Purpose: This study intended to assess the feasibility of an individualized voiding program in Japan aimed at improving the sense of micturition control in older people with functional urinary incontinence. Method: Following the interview guide, FGIs were conducted in two groups (4 - 6 participants) consisting of nurses and care workers with more than 5 years of experience as practitioners of urination care. Data were analyzed using a qualitative descriptive approach. Results: We determined that the program purpose is to “enable caregivers to work as a well-coordinated team to humanely facilitate excretion independence in older people, which is essential for living with dignity”, as this confirmed the importance of maintaining the sense of micturition control in older people for their well-being. In the program outline, we extracted the following five categories: 1) setting selection criteria for recipients considering the status of micturition induction, 2) careful collection of information and assessment of lower urinary tract symptoms in older people in case of environmental changes, 3) examination of methods used for assessing lower urinary tract symptoms according to the facility environment, 4) confirmation of the recipient’s micturition habits and request for assistance, and 5) conducting necessary examination for setting the intervention period and evaluation period according to the target condition. The feedback on the program guide was summarized in the statement—specific successful cases help frame and implement the micturition induction plan. Conclusion: We confirmed the feasibility of the micturition induction plan for improving the sense of control in older people with functional urinary incontinence. Upon evaluating the program guide, we deemed that referring to specific successful cases helps frame and implement the micturition induction plan. It is extremely important to verify the effectiveness of the program going forward.

Sustainable functional urethral reconstruction:Maximizing early continence recovery in robotic-assisted radical prostatectomy

Objective:To evaluate the safety profile and short-term functional outcome of sustainable functional urethral reconstruction(SFUR)in robotic-assisted radical prostatectomy(RARP).Methods:One hundred and sixty-two consecutive prostate cancer patients who underwent RARP were retrospectively analyzed,in which 53 had undergone SFUR while the other 109 had undergone conventional RARP procedures.Immediate,2-week,1-month and 3-month continence recovery and other perioperative data were compared to evaluate short-term surgical and functional outcome.Results:The median age was 68 and 67 years in the experimental group and control group,respectively(pZ0.206),with a median prostate-specific antigen(PSA)of 13.6 ng/mL(interquartile range[IQR],8.46e27.32 ng/mL)in the experimental group and 13.84 ng/mL(IQR,9.12e26.80 ng/mL)in control group(pZ0.846).Immediate,2-week,1-month and 3-month continence recovery rates between the groups were 34.0%vs.3.7%,50.9%vs.14.7%,62.3%vs.27.5%,and 79.2%vs.63.3%(all p<0.05).The morphological changes made by the new reconstruction technique were maintained on magnetic resonance imaging(MRI)3 months postoperatively.Nerve-sparing procedures and adoption of the new reconstruction technique were significantly relevant to continence recovery on logistics regression model(p<0.001).Conclusions:SFUR is a safe and easy-to-handle modification that may contribute to early continence return for RARP.Long-term follow-up and prospective studies are required to further evaluate its value in postoperative quality-of-life improvement.