Acute urinary retention, causes, symptoms, first emergency medical care for acute urinary retention.

Acute urinary retention means the inability to empty an empty bladder on its own. This condition must be distinguished from anuria, in which there is no urination due to the fact that the kidneys stop filtering the fluid and form urine. Urinary retention is more common in men.. 

Acute urinary retention, causes, symptoms, first emergency medical care for acute urinary retention.

There are three large groups of causes of acute urinary retention: obstruction of its outflow from the bladder, a malfunction in the nervous system that regulates urination, and various poisonings. A mechanical obstruction to the outflow of urine can be created by an adenoma or malignant tumor of the prostate, an exacerbation of chronic inflammation of this organ, an injury to the urethra or scarring after it, a stone or foreign body wedged into the urethra. In women, acute urinary retention can also be triggered by prolapse of the uterus..

, stroke, etc. Some types of poisoning can lead to urinary retention even in a healthy person. This occurs with an overdose or intolerance to such common medications as sleeping pills and some antidepressants. Narcotic painkillers have a similar effect on the bladder.
For all these reasons, acute urinary retention can develop spontaneously or be triggered by, for example, infection or alcohol..

Symptoms of acute urinary retention.

Acute urinary retention is manifested by a feeling of heaviness and bursting in the suprapubic region, which is extremely unpleasant for the patient. A person constantly feels the urge to urinate, but is not able to empty the bladder. Sometimes with every urge and strong tension of the abdominal muscles several drops of urine leave, but the condition does not improve.

With a long delay, the severity and bursting go into pain, the patient’s temperature rises slightly, the heartbeat intensifies (due to reflex reactions), he is able to lose consciousness. If not assisted, bladder rupture may occur..

First aid for acute urinary retention.

To properly provide emergency care, you must be able to determine the cause of urinary retention. For example, with a prostate tumor, a rough attempt to catheterize the bladder may be ineffective, leading to damage to the urethra and bleeding. Therefore, the first stage of care should be a brief questioning of the patient.

The most important are a few questions. When was the last urination, did it happen in the past, does the person have any diseases that can cause urinary retention (many patients themselves can name the cause of their condition), has he recently taken any medications that can provoke this? In older men, first of all, you need to ask if they suffer from prostate adenoma and how urine passed before. Prostate adenoma is characterized by frequent urination, a sluggish stream of urine.

There are two ways to try to empty the bladder. Reflex and through the introduction of a catheter into the bladder. First (or if it is not possible to perform catheterization of the bladder), they resort to the reflex method. Washing the perineum with warm water – the sounds of pouring water at the same time also help urination. If there is no effect and there is an appropriate skill, the catheter is inserted into the bladder who is helping.

If the patient has an abnormal location of the urethra or with a triple technically correct attempt to insert a catheter failed, you should wait for the help of doctors. From drugs that can promote urination, a 1% solution of pilocarpine hydrochloride (1 ml) and a 0.05% solution of proserin (1 ml) are isolated. If these medications are available at the prehospital stage, you can enter them under the skin. All patients with acute urinary retention should be hospitalized..

Based on the book “Quick help in emergency situations”.
Kashin S.P..

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