Consequently, it is important that clinicians identify patients with CUR at risk for morbidity but not expose all patients with CUR to costly and even potentially harmful interventions.ĬUR definitions using physical exam findings have been proposed but have had limited clinical adoption. 1 Medications and surgical procedures for reducing CUR can likewise cause temporary or permanent harm. Indwelling and intermittent catheterization can cause UTIs, urethral trauma, and negatively affect quality of life (QOL). However, not all patients with CUR necessarily require treatment, and for such patients, interventions can place them at risk for complications. Associated with either underactive bladder or chronic outlet obstruction, the condition is important because CUR can be associated with hydronephrosis, renal failure, chronic urinary tract infections (UTIs), urinary incontinence, and can lead to a complete inability to void. Non-neurogenic chronic urinary retention (CUR) can be challenging to diagnose and treat because there is no consensus on the criteria that define CUR. Jennifer Bertsch, Emma Hitt, PhD, ELS (Medical Writer), Heddy Hubbard, PhD, MPH, RN, FAAN, MS, Suzanne Pope, MBA, Victoria Wilder (Medical Librarian) Introduction
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Section Meeting Request for Course of ChoiceĬonfidentiality Statement for Online EducationĪdvanced Practice Providers Speaker's BureauĪctivities for the AUA Leadership Program Urology Residency ProgramsĪdditional Fellowships for InternationalsĬontinuing Medical Education & AccreditationĪUA Continuing Education (CE) Mission Statement Transgender and Gender Diverse Patient CareĪccredited Listing of U.S. Request a Hands-on Urologic Ultrasound Course Training Guidelines for Urologic Ultrasound Urologic Ultrasound Practice Accreditation Practice Guideline for Urologic Ultrasound Young Urologists Annual Meeting Programming Young Urologists of the Year Award Winners Residents and Fellows Committee Teaching AwardĪUA Residents and Fellows Committee Teaching Award Residents and Fellows Committee Essay Contest In-Section Countries World Bank ClassificationĪUA Advanced Practice Provider of the Year Award International Member World Bank Classification Based on the results of the current study it seems premature to recommend a cutoff value leading to therapeutic consequences.Volunteer Opportunities for Residents and Young Urologists No cutoff value could be determined to predict positive urine culture with sufficient sensitivity and specificity. Confirming urinary tract infection, this cutoff showed only 28% sensitivity and 94% specificity (AUC 0.606, p = 0.01). In 29 men (13%) post-void residual volume was 180 ml or greater. Patients presenting with urinary tract infection had significantly higher mean post-void residual urine volume than patients without urinary tract infection (113 vs 41 ml, p <0.001). However, in 31% of the study group urine culture was positive. Of the study group 60% were able to completely empty the bladder and had a post-void residual urine volume of 10 ml or less. Using ROC analysis a cutoff predicting bacteriuria was calculated. In a prospective study we analyzed certain criteria in 225 asymptomatic male patients, including prostate specific antigen, prostate volume, International Prostate Symptom Score, peak urine flow rate, urine culture results and post-void residual urine volume using transabdominal ultrasound. We determined the association between post-void residual urine volume and urinary tract infection, and validated the suggested 180 ml cutoff in asymptomatic men. Recently investigators calculated that a cutoff value of 180 ml has considerably high sensitivity and specificity for significant bacteriuria in asymptomatic men. Post-void residual urine can lead to various complications, including urinary tract infection.
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