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Common Urinary Retention exam questions for medical finals, OSCEs and MRCP PACES


Question 1.

List three drugs you should specifically ask a patient in urinary retention:

  • Tricyclic medication
  • Anti-muscarinic medication
  • Opiates
  • Anti-histamines
  • Cold and flu remedies


Question 2.

What are the treatments for BPH?

  • Conservative
    • Avoid caffeine and alcohol, regular voiding, distraction methods and bladder training
  • Medical
    • Alpha blockers such as Tamsulosin, 5-alpha reductase inhibitors e.g. finasteride
  • Surgical
    • Transurethral resection of prostate (TURP), transurethral incision of prostate (TUIP), retropubic prostatectomy, transurethral laser-induced prostatectomy.


Question 3.

How should you investigate and treat acute urinary retention?

  • Full history and examination
  • Urine dip and MSU
  • U&Es, FBC and clotting (G&S if frank haematuria)
  • Blood glucose
  • Consider PSA if suspicious prostate
  • Catheterise
    • Post-catheter: Measure residual volume of bladder in first 10-15 minutes
    • Residual volumes of greater than one litre make patients more likely to fail a trial without catheter (TWOC) and increase the chances of have recurrent retention
  • Post-catheterisation patients may be admitted if they have:
    • Clot retention
    • Complicated renal colic
    • Frank haematuria
    • Social reasons or lots of co-morbidities
    • Greater than two litres of residual urine
  • Post-catheterisation patients may be sent home if they have none of the issues above