Incidence and risk factors for urinary retention in critically ill patients

Use of ultrasonography in the evaluation of urinary retention in critically ill patients

OBJECTIVE

to measure urinary volume through bladder ultrasound, performed by a nurse in critically ill patients, after removal of the indwelling urinary catheter and to verify the related factors on urinary retention.

METHOD

quantitative, observational and cross-sectional study, carried out with 37 critically ill patients of both sexes, over 18 years of age, with removal of indwelling urinary catheter in the last 48 hours. A questionnaire containing sociodemographic and clinical variables and an ultrasound examination were used. Data were presented through frequency distribution, centrality and variability measures, association using Fisher`s exact test and, for analysis multiple binomial logistic regression analysis.

RESULTS

the 37 patients were mostly male, with a mean age of 54.9 years. The measurement of urinary volume by ultrasound ranged from 332.3 to 950 ml, and 40.54% of patients had urinary retention. Urinary retention was significantly associated with the occurrence of urinary tract infection, intestinal constipation and spontaneous overflow diuresis. Patients with urinary tract infection were 7.4 times more likely to have urinary retention.

CONCLUSION

bladder ultrasonography was effective in measuring urinary volume after removal of the indwelling urinary catheter and and may contribute to the detection of urinary retention. (1) Ultrasonography of the bladder showed an advantage for a better nursing diagnosis. (2) Critical patients had urinary retention after removal of urinary catheter. (3) Overflow incontinence was detected after removal of the urinary catheter. (4) Patients with urinary tract infection were 7.4 times more likely to have retention.

Effect Observation on Modified Zishen Tongguan Decoction Combined with Acupuncture in Treatment of Urinary Retention after Cervical Cancer Surgery and Its Influence on the Incidence of Adverse Reactions

OBJECTIVE

To explore the effect observation on modified Zishen Tongguan decoction combined with acupuncture in the treatment of urinary retention after cervical cancer surgery and its influence on the incidence of adverse reactions.

METHODS

The clinical data of 84 patients suffered from urinary retention after radical resection of cervical cancer (December 2018-December 2019) in the oncology department of Jinan Municipal Hospital of Traditional Chinese Medicine were selected for retrospective analysis. According to the order of admission, they were divided into group A (n = 42), treated with conventional therapy, modified Zishen Tongguan decoction, and acupuncture, and group B (n = 42), treated with conventional therapy. The clinical efficacy of the two groups was observed, the urination function indexes after therapy were recorded, and the clinical efficacy and incidence of adverse reactions were analyzed.

RESULTS

After therapy, compared with group B, the average urinary flow rate, maximum urinary flow rate, bladder compliance (BC) level value, and the number of patients with good recovery of bladder function of group A were obviously higher (P < 0.05), and the urination time and detrusor pressure were obviously lower (P < 0.001). There was no significant difference in the average scoring of overactive bladder syndrome score (OABSS) between the two groups at 7 days of therapy (p > 0.05). The average OABSS of group A at 14 days of therapy was obviously lower than that of group B (P < 0.001). Compared with group B, the total clinical effective rate of group A was obviously higher (P < 0.05), while the total incidence of adverse reactions was obviously lower (P < 0.05).

CONCLUSION

Modified Zishen Tongguan decoction combined with acupuncture is a reliable method to treat urinary retention after cervical cancer surgery, which greatly improves the urination function of patients, as well as the clinical efficacy. Further research will help create a better solution for patients with urinary retention after cervical cancer surgery.

Urinary Retention and Severe Hyponatremia: An Unusual Presentation of COVID-19

Coronavirus disease 2019 (COVID-19) was first reported in Wuhan, China, in December 2019. The disease is caused by severe acute respiratory syndrome virus coronavirus 2 (SARS-CoV-2). A few published cases have linked COVID-19 and hyponatremia. The mechanism of hyponatremia in these cases is related to the syndrome of inappropriate antidiuretic hormone secretion (SIADH). Here we present a unique case of urinary retention and SIADH as unusual presenting features of SARS-CoV-2 infection.

LEARNING POINTS

Urine retention could be an unusual presenting symptom of severe hyponatremia of COVID-19.Hyponatremia and SIADH could be unusual presenting features of SARS-CoV-2 infection.Careful correction of hyponatremia related to COVID-19 is necessary to avoid osmotic demyelination syndrome.