Introduction
Urinary retention occurs frequently and the prevalence ranges from 5 % to 70 % during anesthesia and surgery. The emergence of postoperative urinary retention (POUR) is influenced by comorbidities, the nature of the surgery, and the type of anesthetic. The prevention and management of POUR during the perioperative phase are suggested using an evidence-based strategy. Anesthesia is an essential part of modern medicine, allowing for safe and effective surgical procedures to be performed. However, anesthesia can have several side effects, including urinary retention. Urinary retention is a condition where the bladder cannot empty completely at all, leading to discomfort and sometimes even urinary tract infections. In this article, we will discuss the effects of anesthesia on urinary retention and how it can be managed.
What Is Postoperative Urinary Retention?
Bladder catheterization is a routine treatment that allows for monitoring urine output, directs volume resuscitation, and acts as an indicator of hemodynamic stability during inpatient major surgery. It becomes more important to be aware of and identify patients who may experience postoperative urinary retention (POUR). The inability to void while one's bladder is full is known as POUR. This article examines POUR-causing perioperative variables and explores the physiology of micturition. There are also evidence-based recommendations for managing POUR.
What Are the Symptoms of Urinary Retention Post Anesthesia?
Urinary retention is a medical condition where a person is unable to fully empty their bladder. The commonly seen symptoms of urinary retention can include:
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Difficulty starting urination.
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Weak or interrupted urine flow.
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Dribbling at the end of urination.
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Pain or discomfort during urination.
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Feeling the need to urinate frequently, but only being able to pass small amounts of urine.
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Abdominal bloating or discomfort.
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Urinary tract infections (UTIs) that recur or do not respond to treatment.
What Are the Effects of Anesthesia on Urinary Retention?
Anesthesia can affect the muscles that control urination, causing urinary retention. This is especially true for surgeries that involve the lower abdomen or pelvis. The muscles in this area can be weakened or paralyzed by the anesthetic, making it difficult or impossible for the patient to urinate normally. Additionally, some types of anesthesia, such as epidural or spinal anesthesia, can cause a decrease in blood pressure, which can also affect the ability to urinate. Urinary retention can be a serious problem, especially for patients who are undergoing prolonged surgical procedures. If the bladder becomes too full, it can lead to bladder distension, which can cause pain and discomfort. In severe cases, urinary retention can lead to bladder damage, urinary tract infections, or even kidney damage.
The following are the effects of anesthesia on urinary retention:
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Effects of General Anesthetic Agents - General anesthetic agents cause bladder disturbances by interfering with the signals of the nervous system. Diazepam, Pentobarbital, and Propofol all decrease contractions of the bladder. Halothane also increases bladder capacity.
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Blockage Conduction - The sensation of urgency to urinate disappears 30 to 60 seconds after injection of local anesthetics, but a dull feeling of tension on the maximal filling of the bladder persists. The block of micturition contraction occurs approximately 16 minutes after injection of morphine and lasts between 250 and 350 minutes.
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Spinal Opioids - The block of micturition contraction occurs approximately 16 minutes after injection of morphine. The use of long-acting local anesthetics is related to a higher incidence of POUR.
What Are the Complications of Urinary Retention Post Anesthesia?
There are different complications associated with urinary retention. The following are the complications of urinary retention:
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Autonomic Response - An overextended bladder can provide painful stimulation that can result in vomiting, bradycardia, hypotension, hypertension, and cardiac dysrhythmias. Postoperative urinary retention has been demonstrated to increase the time till discharge for 19 % of outpatients and lengthen the hospital stay for patients.
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Infection - Urinary infection can be a direct complication of persistent POUR as a consequence of bladder inability to completely empty the bladder. The mortality rate is high in this case.
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Bladder Overdistension - Bladder overdistension is a potentially serious adverse effect associated with POUR, and it has a reported incidence of 44 %.
What Is the Treatment of Urinary Retention Post Anesthesia?
If a patient experiences urinary retention after anesthesia, there are several steps that can be taken to manage the condition. One of the most common methods is the use of a catheter. A catheter is a thin, flexible tube that is inserted into the bladder through the urethra to drain urine. This can provide relief for the patient and prevent bladder damage. In some cases, medications may be prescribed to help relax the muscles of the bladder and improve urinary function. These medications may include anticholinergics, alpha-blockers, or beta-agonists. These medications can help to relieve the symptoms of urinary retention and improve bladder function. Bladder catheterization is the standard treatment of POUR. Catheterization of the bladder is required for monitoring urinary output after major surgery, guiding the volume of the urine, and preventing POUR.
How to Prevent Urinary Retention?
Prevention is always better than treatment, and there are several measures that can be taken to reduce the risk of urinary retention after anesthesia. One of the most important steps is to ensure that the patient is adequately hydrated before the surgery. This can help to promote normal bladder function and reduce the risk of urinary retention. During the surgery, the anesthesiologist can also take steps to reduce the risk of urinary retention. For example, they may use a regional anesthetic rather than a general anesthetic, or use a lower dose of anesthetic to minimize its effects on the bladder muscles.
Conclusion:
Urinary retention is a common side effect of anesthesia, but it can be managed effectively with the right treatment. If someone is scheduled to undergo surgery, talk to the doctor and anesthesiologist about the risks of urinary retention and what steps can be taken to reduce your risk. By taking the right precautions and seeking prompt treatment if someone experiences urinary retention, they can minimize the impact of this condition and promote a speedy recovery. Bladder catheterization is the treatment of the choice of urinary retention.
