Uti

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ANATOMY AND PHYSIOLOGY

UTIs
bladder damage
kidney damage
urinary incontinence after
prostate, tumor, or cancer
surgery
Women with mild cystocele or
rectocele may prevent urinary
retention by doing exercises to
strengthen the pelvic muscles.
Dietary and lifestyle changes will help
prevent urinary retention caused by
constipation. People whose constipation
continues should see a health care provider.
How is urinary retention
diagnosed?
Physical Exam
A health care provider may
suspect urinary retention
because of a patient’s
symptoms and, therefore,
perform a physical exam of
the lower abdomen. The
health care provider may
be able to feel a distended
bladder by lightly tapping
on the lower belly.
Postvoid Residual
Measurement
A postvoid residual
measurement test measures
the amount of urine left in
the bladder after urination.
The remaining urine is called
the postvoid residual. A
specially trained technician
performs an ultrasound,
which uses harmless sound
waves to create a picture of
the bladder, to measure the
postvoid residual.
•CT scans. CT scans use a
combination of x-rays and
computer technology to
create images. For a CT scan,
a health care provider may
give the patient a solution to
drink and an injection of a
special dye, called contrast
medium. CT scans require
the patient to lie on a table
that slides into a tunnel-
shaped device where a
technician takes the x-rays.
-urinary tract stones
-UTIs
-tumors
-traumatic injuries
-abnormal,fluid-
containing sacs called
cysts
URODYNAMIC TESTS
Urodynamic tests include a variety of procedures that

look at how well the bladder and urethra store and
release urine. A health care provider may use one or
more urodynamic tests to diagnose urinary retention.
Uroflowmetry
• Uroflowmetry
measures urine
speed and volume.
Uroflowmetry equipment includes a device for catching

and measuring urine and a computer to record the data.
The equipment creates a graph that shows changes in
flow rate from second to second so the health care
provider can see the highest flow rate and how many
seconds it takes to get there. A weak bladder muscle or
blocked urine flow will yield an abnormal test result.
Pressure flow study
• A pressure flow study measures the bladder pressure

required to urinate and the flow rate a given pressure
generates. A health care provider places a catheter with a
manometer into the bladder. The manometer measures
bladder pressure and flow rate as the bladder empties. A
pressure flow study helps diagnose bladder outlet
obstruction.
Video urodynamics
This test uses x-rays or ultrasound to create real-

time images of the bladder and urethra during the
filling or emptying of the bladder. For x-rays, a health
care provider passes a catheter through the urethra
into the bladder. Video urodynamic images can show
the size and shape of the urinary tract, the flow of
urine, and causes of urinary retention, such as
bladder neck obstruction.
Electromyography
Electromyography uses special

sensors to measure the electrical
activity of the muscles and nerves
in and around the bladder and
sphincters. A specially trained
technician places sensors on the
skin near the urethra and rectum
or on a urethral or rectal catheter.
The sensors record, on a
machine, muscle and nerve
activity. The patterns of the nerve
impulses show whether the
messages sent to the bladder and
sphincters coordinate correctly.
Chronic urinary retention can be a
long-lasting medical condition. People
with chronic urinary
retention can urinate. However, they
do not completely empty all of
the urine from their bladders.
Bladder drainage involves
catheterization to drain
urine. Treatment of acute
urinary retention begins
with catheterization to
relieve the immediate
distress of a full bladder
and prevent bladder
damage.
Urethral dilation treats urethral stricture by
inserting increasingly wider tubes into the urethra
to widen the stricture. An alternative dilation
method involves inflating a small balloon at the
end of a catheter inside the urethra.
Another treatment for
urethral stricture
involves inserting an
artificial tube, called a
stent, into the urethra to
the area of the
stricture.
Medications that stop the growth of or shrink the
prostate or relieve urinary retention symptoms
associated with benign prostatic hyperplasia include
•dutasteride (Avodart)
•finasteride (Proscar)
The following medications relax the muscles of the
bladder outlet and prostate to help relieve blockage:
•alfuzosin (Uroxatral)
•doxazosin (Cardura)
•silodosin (Rapaflo)
•tadalafil (Cialis)
•tamsulosin (Flomax)
•terazosin (Hytrin)
To treat urinary
retention caused by
benign prostatic
hyperplasia, a
urologist—a doctor who
specializes in the
urinary tract—may
surgically destroy or
remove enlarged
prostate tissue by using
the transurethral
method.
Internal urethrotomy.
A urologist can repair a urethral

stricture by performing an internal
urethrotomy. For this procedure, the
urologist inserts a special catheter into
the urethra until it reaches the stricture.
Cystocele or rectocele repair.
Women may need surgery to lift a fallen

bladder or rectum into its normal position.
The most common procedure for cystocele
and rectocele repair involves a urologist, who
also specializes in the female reproductive
system, making an incision in the wall of the
vagina.
Tumor and cancer surgery
Removal of tumors and cancerous
tissues in the bladder or urethra
may reduce urethral obstruction and
urinary retention.
NURSING INTERVENTIONS

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ANATOMY AND PHYSIOLOGY

Urodynamic tests include a variety of procedures that

Uroflowmetry equipment includes a device for catching

• A pressure flow study measures the bladder pressure

This test uses x-rays or ultrasound to create real-

Electromyography uses special

A urologist can repair a urethral

Women may need surgery to lift a fallen

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