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Lopes Mendes AL, Innocenzi M, Spicchiale CF, Collura G, Mele E, Del Prete L, Castagnetti M. Acute urinary retention in children: causes and the role of bladder catheterization and ultrasonogram. Minerva Urol Nephrol 2024; 76:499-504. [PMID: 38618703 DOI: 10.23736/s2724-6051.24.05696-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
BACKGROUND Acute urinary retention in children is uncommon and can be related to several causes. The role of abdominal ultrasound and catheterization is controversial. We aimed to identify the most common causes of acute urinary retention in children, focusing, particularly on the role of bladder catheterization and the diagnostic value of acute ultrasound. METHODS We retrospectively analyzed all consecutive children admitted to our emergency department with acute urinary retention from 2010 to 2020. Post-operative acute urinary retention, neonatal age, and known urological or neurological disorders were excluded. Diagnostic workup and management were adopted in each patient. Results were compared in patients with more and less than 5 years old. RESULTS 193 patients were included. Median age was 3 (2-16) years; 53.4% were girls. Ultrasound evaluation was performed in (129/193; 66.8%) patients, more commonly <5-year-old (74% vs. 26%, P<0.01). A previously unknown urological condition was detected in (16/129; 12%). The majority of patients (124/193; 64%) were managed without bladder catheterization. These patients were significantly younger than the remainder (3- vs. 4-year-old, P<0.01) and the most common diagnosis was external genitalia inflammation (53%). Of the remaining patients, (34/69; 49%) restored spontaneous micturition after a single catheterization, whereas 35 required admission. The latter were more commonly males (32%, P=0.01), with higher incidence of abnormal ultrasound (33% vs. 7%, P<0.001). CONCLUSIONS Acute urinary retention in commonly due to external genitalia inflammation, particularly in patients <5-year-old, and can be generally managed, without bladder catheterization. Abdominal ultrasound is an important diagnostic tool, that should be performed only in selected cases.
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Affiliation(s)
- Ana L Lopes Mendes
- Pediatric Urology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy -
| | - Michele Innocenzi
- Pediatric Urology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Claudia F Spicchiale
- Pediatric Urology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
- Tor Vergata University, Rome, Italy
| | - Giuseppe Collura
- Pediatric Urology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Ermelinda Mele
- Pediatric Urology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Laura Del Prete
- Pediatric Urology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Marco Castagnetti
- Pediatric Urology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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Hekmati P, Arshadi H, Kamran H, Kajbafzadeh A, Zahir M, Amirzargar H, Ghahestani SM. Three rare etiologies of urinary retention in pediatrics: A case series and review of the literature. Clin Case Rep 2023; 11:e8125. [PMID: 37927982 PMCID: PMC10622406 DOI: 10.1002/ccr3.8125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/05/2023] [Accepted: 10/09/2023] [Indexed: 11/07/2023] Open
Abstract
Etiology of urinary retention in pediatric age differs significantly from adults and the elderly. Therefore, a comprehensive diagnosis is crucial before specific treatment. Every effort must be made to minimize invasive procedures as far as possible in children.
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Affiliation(s)
- Pooya Hekmati
- Department of Pediatric Urology, Pediatric Urology and Regenerative Medicine Research Center, Pediatrics Center of ExcellenceTehran University of Medical SciencesTehranIran
| | - Hamid Arshadi
- Department of Pediatric Urology, Pediatric Urology and Regenerative Medicine Research Center, Pediatrics Center of ExcellenceTehran University of Medical SciencesTehranIran
| | - Hooman Kamran
- Department of Pediatric Urology, Pediatric Urology and Regenerative Medicine Research Center, Pediatrics Center of ExcellenceTehran University of Medical SciencesTehranIran
- Student Research CommitteeShiraz University of Medical SciencesShirazIran
| | - Abdol‐Mohammad Kajbafzadeh
- Department of Pediatric Urology, Pediatric Urology and Regenerative Medicine Research Center, Pediatrics Center of ExcellenceTehran University of Medical SciencesTehranIran
| | - Mazyar Zahir
- Department of Pediatric Urology, Pediatric Urology and Regenerative Medicine Research Center, Pediatrics Center of ExcellenceTehran University of Medical SciencesTehranIran
- Urology and Nephrology Research CenterShahid Beheshti University of Medical SciencesTehranIran
| | - Hossein Amirzargar
- Department of Pediatric Urology, Pediatric Urology and Regenerative Medicine Research Center, Pediatrics Center of ExcellenceTehran University of Medical SciencesTehranIran
| | - Seyyed Mohammad Ghahestani
- Department of Pediatric Urology, Pediatric Urology and Regenerative Medicine Research Center, Pediatrics Center of ExcellenceTehran University of Medical SciencesTehranIran
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Crigger C, Kuzbel J, Al-Omar O. Choosing the Right Catheter for Pediatric Procedures: Patient Considerations and Preference. Res Rep Urol 2021; 13:185-195. [PMID: 33954151 PMCID: PMC8092428 DOI: 10.2147/rru.s282654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 03/30/2021] [Indexed: 11/23/2022] Open
Abstract
Determining the need for bladder decompression and urinary diversion in the perioperative pediatric surgical patient can cause a clinical conundrum for the surgical team. Add in the several different types of urinary diversion devices possible, and the various materials associated therein and the process can suddenly seem unnecessarily daunting given the lack of concise recommendations and broad consensus. The decision to divert urine, though seemingly trivial, is associated with inherent risks. Managing and mitigating certain risks are best approached through proper education, selection, and technique. We provide a broad overview of pediatric catheter selection, indications, and pitfalls to streamline the process so that energy and attention can best be focused on the planned intervention at hand.
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Affiliation(s)
- Chad Crigger
- Department of Urology, Division of Pediatric Urology, West Virginia University, Morgantown, WV, 26506, USA
| | - Jake Kuzbel
- Department of Urology, Division of Pediatric Urology, West Virginia University, Morgantown, WV, 26506, USA
| | - Osama Al-Omar
- Department of Urology, Division of Pediatric Urology, West Virginia University, Morgantown, WV, 26506, USA
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Kini S, Bhat RY, Karegowda LH. Micturition Disturbance: A Predominant Feature of Acute Disseminated Encephalomyelitis. JOURNAL OF PEDIATRIC NEUROLOGY 2021. [DOI: 10.1055/s-0040-1722617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AbstractUrinary retention in children can have varied etiology ranging from anatomic to functional causes. Functional causes include neuropathies, including rare central nervous system (CNS) involvement, such as acute disseminated encephalomyelitis (ADEM). ADEM is usually preceded by acute viral infection and commonly presents with multifocal neurological deficits. The ADEM diagnosis is mainly based on the clinical presentation and its correlation with characteristic CNS findings on magnetic resonance imaging (MRI). Here, we report an adolescent boy who presented with acute urinary retention preceded by an acute febrile illness. The patient was worked up thoroughly, including an MRI of the brain and spine, which revealed ADEM's characteristic features. The bladder function was evaluated periodically. The voiding dysfunction persisted for a long time. Treatment with steroids and other supportive therapy ultimately lead to a complete recovery over 6 months.
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Affiliation(s)
- Sandesh Kini
- Department of Paediatrics, Kasturba Medical College, Manipal Academy of Higher Education University, Manipal, Karnataka, India
| | - Ramesh Y. Bhat
- Department of Paediatrics, Kasturba Medical College, Manipal Academy of Higher Education University, Manipal, Karnataka, India
| | - Lakshmikanth Halegubbi Karegowda
- Department of Radiodiagnosis and Imaging, Kasturba Medical College, Manipal Academy of Higher Education University, Manipal, Karnataka, India
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Schmidt AM, Hirsch K, Schroth M, Stehr M, Schäfer FM. Acute urinary retention in children. J Pediatr Urol 2020; 16:842.e1-842.e6. [PMID: 32900634 DOI: 10.1016/j.jpurol.2020.08.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 06/15/2020] [Accepted: 08/15/2020] [Indexed: 01/29/2023]
Abstract
BACKGROUND Acute urinary retention is a common emergency in adult patients, foremost in older men. In childhood urinary retention is a rare entity with only sparse literature on the etiology. OBJECTIVE To assess the etiology and treatment of acute urinary retention in the pediatric population and assess age and sex distribution. STUDY DESIGN A retrospective analysis of all patients admitted to our emergency department with acute urinary retention between 2005 and 2019 was performed. Exclusion criteria were newborns (because of physiologic postnatal oliguria) and postoperative urinary retention during the same hospital stay. RESULTS 113 children with acute urinary retention (ICD: R33) meeting the above criteria were identified. 16 Patients were excluded because of incomplete medical charts. 97 children were included into the study (age 0.5-18.3 years, mean age 5.3 years). 89 patients had one episode, 8 patients two episodes. A peak around the third year of age was observed. Sex ratio showed a 2:1 male to female distribution. Most common etiology was balanoposthitis (15.5%) and acute constipation/fecal impaction (15.5%). Traumatic urinary retention was found in 11.4% of the cases. Urinary tract infection were found 7.2%. No underlying reason could be found in 12.4% (idiopathic urinary retention). Other causes included febrile non-urinary infection (8.2%), subvesical obstruction (4.1%), vulvovaginitis (3.1%) and urethritis (2.1%). In 50% of the cases of urinary retention under 1 year of age (2 out of 4) an underlying tumor (rhabdomyosarcoma, sacral teratoma) was identified. DISCUSSION Age and sex distribution were similar to previously published series; however, this study shows a marked difference concerning the etiology: e. g. we identified a significantly higher proportion of functional disorders as a reason for acute urinary retention in childhood. It is hypothesized that this is partly because previously published studies originate from areas (USA, Israel, Iran) with different socio-demographic and cultural background. CONCLUSION AUR in children is a rare condition with very heterogeneous causes. Although the majority of cases exhibit mild underlying conditions, serious reasons, such as malignant diseases especially in the first year of life, must be excluded. AUR relief without catheterization is a child-friendly approach in cases of mild inflammatory or functional disorders and can help to minimize traumatization.
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Affiliation(s)
- Ana-Marija Schmidt
- Department of Pediatric Surgery and Pediatric Urology, Cnopfsche Kinderklinik, St. Johannis-Mühlgasse 19, 90419, Nürnberg, Germany
| | - Karin Hirsch
- Department of Urology and Pediatric Urology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), 91054, Erlangen, Germany
| | - Michael Schroth
- Department of Pediatrics and Pediatric Emergency Care, Cnopfsche Kinderklinik, St. Johannis-Mühlgasse 19, 90419, Nürnberg, Germany
| | - Maximilian Stehr
- Department of Pediatric Surgery and Pediatric Urology, Cnopfsche Kinderklinik, St. Johannis-Mühlgasse 19, 90419, Nürnberg, Germany
| | - Frank-Mattias Schäfer
- Department of Pediatric Surgery and Pediatric Urology, Cnopfsche Kinderklinik, St. Johannis-Mühlgasse 19, 90419, Nürnberg, Germany.
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Park HE, Lee JS, Kim DM, Shin YB. Two Pediatric Cases of Successful Management of Postictal Transient Urinary Retention. Ann Rehabil Med 2020; 44:90-93. [PMID: 32130843 PMCID: PMC7056328 DOI: 10.5535/arm.2020.44.1.90] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 08/28/2019] [Indexed: 01/23/2023] Open
Abstract
We report two cases of postictal urinary retention in pediatric patients with cognitive impairment. Two girls with intellectual disabilities, concomitant cerebral palsy (case 1) and Rett syndrome (case 2), developed urinary retention following seizures. Their caregivers brought them to the hospital with complaints of abdominal distension. After excluding neurological progression, they were referred to the rehabilitation clinic for the evaluation and management of postictal urinary retention. We followed two different approaches in each case to restore normal urination. While serial manual cystometrograms were performed in case 1, clean intermittent catheterization with a voiding diary was performed in case 2 until restoration of normal urination. Based on these pediatric cases of successfully managed postictal urinary retention, we suggest that more attention may be needed for children with cognitive impairment to diagnose and manage postictal urinary retention.
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Affiliation(s)
- Ho Eun Park
- Department of Rehabilitation Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Je-Sang Lee
- Department of Rehabilitation Medicine, Gimhae Hansol Rehabilitation & Convalescent Hospital, Gimhae, Korea
| | - Dong Min Kim
- Department of Rehabilitation Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Yong Beom Shin
- Department of Rehabilitation Medicine, Pusan National University School of Medicine, Busan, Korea
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Keskinen H, Helenius L, Pajulo O, Helenius IJ. Postoperative urinary retention or difficulties to empty the bladder in young patients undergoing posterior spinal fusion for adolescent idiopathic scoliosis. J Pediatr Surg 2018; 53:1542-1546. [PMID: 29153469 DOI: 10.1016/j.jpedsurg.2017.09.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 09/11/2017] [Accepted: 09/11/2017] [Indexed: 01/26/2023]
Abstract
BACKGROUND Postoperative urinary retention has been reported to affect up to 27% of adults undergoing degenerative lumbar spine surgery and approximately one-third of children undergoing lower-extremity orthopedic surgery. No data exist on the incidence and risk factors of postoperative urinary tract retention/difficulties to empty the bladder in young patients undergoing instrumented posterior spinal fusion. We aimed to characterize incidence, risk factors and treatment of postoperative urinary retention (POUR) and difficulties to empty the bladder in young patients undergoing posterior spinal fusion (PSF) for idiopathic scoliosis. METHODS One hundred and eleven consecutive patients (mean age 16years [range, 11-21years], 81 females and 30 males) undergoing PSF for adolescent idiopathic scoliosis were screened after removal of urinary catheter postoperatively for inability to void and residual volume of urinary bladder. The latter was measured using ultrasound on two separate occasions. POUR and the need for intermittent catheterization were defined as an inability to void after catheter removal and documented full bladder with ultrasound (a residual of 300mL or more) or a significant residual volume after voiding (>2mL/kg or >100mL). RESULTS Fifty-one (46%) of the patients were either unable to void or had a clinically significant amount of residual volume after voiding. These fifty-one patients required intermittent catheterization for a mean of two days. Thirty patients (27%) had POUR, a residual volume of 300mL or more. Two (1.8%) patients experienced urinary tract infection postoperatively. Patients with urinary retention had a significantly higher mean intraoperative blood loss (mean 626mL vs. 464mL; p=0.020) and longer operation time (mean 3.3h vs. 2.8h; p=0.009) as compared with those not having urinary retention. In multivariate analyses the main risk factor for urinary retention was male gender (odds ratio 3.2 [95% confidence interval 1.1-9.2], p=0.028). CONCLUSIONS Postoperative voiding difficulties affect almost half of the patients with age under 21years undergoing PSF for idiopathic scoliosis. The main risk factors were increased intraoperative blood loss, longer length of surgery and male gender. POUR should be actively screened and treated in this patient population. LEVEL OF EVIDENCE Prospective Cohort Study II.
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Affiliation(s)
- Heli Keskinen
- Department of Paediatric Orthopaedic Surgery, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, 20520 Turku, Finland.
| | - Linda Helenius
- Department of Paediatric Orthopaedic Surgery, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, 20520 Turku, Finland
| | - Olli Pajulo
- Department of Paediatric Orthopaedic Surgery, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, 20520 Turku, Finland
| | - Ilkka J Helenius
- Department of Paediatric Orthopaedic Surgery, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, 20520 Turku, Finland
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Costa JND, Botelho ML, Duran ECM, Carmona EV, Oliveira-Kumakura ARDS, Lopes MHBDM. Conceptual and Operational Definitions for the Nursing Diagnosis "Urinary Retention". Int J Nurs Knowl 2017; 30:49-54. [PMID: 29214730 DOI: 10.1111/2047-3095.12196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE To develop conceptual and operational definitions for defining characteristics and related factors for nursing diagnosis of urinary retention, as contained in Taxonomy II of NANDA-I. DATA SOURCES Integrative literature review and elaboration of terms related to urinary retention. DATA SYNTHESIS It includes operational and conceptual definitions of the nursing diagnosis urinary retention. CONCLUSIONS It is necessary to review the definition of this nursing diagnosis and most of its defining characteristics and related factors. IMPLICATIONS FOR NURSING PRACTICE The use of internationally known terms for various disciplines in areas of common knowledge helps to standardize the language used by professionals.
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Affiliation(s)
- Juliana Neves da Costa
- Doctoral Student at Faculty of Nursing (FENF), University of Campinas (UNICAMP), Campinas, SP, Brazil
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Chern BZH, Rajaraman S, Verma G, Heng KWJ. Unusual case of acute urinary retention in a young female. BMJ Case Rep 2017; 2017:bcr-2017-221411. [PMID: 28978599 DOI: 10.1136/bcr-2017-221411] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
We report an unusual case of a 17-year-old young female presenting to the emergency department with varicella infection, acute urinary retention (AUR) and no other neurological deficits. An MRI of the spine confirmed the diagnosis of acute transverse myelitis. Positive serum IgG antibodies against varicella zoster virus (VZV) suggested a parainfectious aetiology. The patient eventually developed weakness and a sensory level from the third thoracic dermatome on day 2 of hospitalisation. Awareness that AUR can precede other neurological deficits in VZV transverse myelitis will prevent misdiagnosis and allow for the prompt treatment of this debilitating illness.
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Affiliation(s)
- Belinda Zer Hui Chern
- School of Medicine, National University Singapore Yong Loo Lin, Singapore, Singapore
| | - Shivani Rajaraman
- School of Medicine, National University Singapore Yong Loo Lin, Singapore, Singapore
| | - Geetika Verma
- School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Yağmur I, Turna B, Tekin A, Akıncıoğlu E, Sarsık B, Ulman İ. Benign prostatic hyperplasia: Case report of a 17-year-old. J Pediatr Urol 2016; 12:267.e1-4. [PMID: 27593922 DOI: 10.1016/j.jpurol.2016.04.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 04/27/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Benign prostatic hyperplasia (BPH) is generally common in men older than 50 years of age but is extremely rare in childhood. In the literature to date, fewer than five cases have been reported under 18 years of age. Owing to the limited number of cases, the etiology and management of BPH in the first two decades is not clear. OBJECTIVE We herein report a 17-year-old boy who presented with acute urinary retention due to BPH and was treated with endoscopic transurethral resection of the prostate (TUR-P). CASE REPORT A 17-year-old male patient with a history of intermittent hematuria was admitted elsewhere with acute urinary retention. An increase in prostate size was detected on digital rectal examination. Pelvic ultrasound revealed a large mass arising from the prostate and filling the bladder lumen. Transrectal ultrasound-guided prostate biopsy (TRUS-Bx) was performed to exclude malignancy. After the documentation of benign prostate tissue in the histopathological analysis, the patient was referred to our clinic for further evaluation and management. Magnetic resonance (MR) imaging revealed a 48 × 55 × 68 mm mass arising from the middle lobe of prostate and filling the bladder lumen (Figure) with an initial diagnosis of a non-ductal malignant tumor because of his age. Enlarged lymph nodes or any sign of metastasis were not detected. Re-examination of the previous biopsy specimens confirmed the absence of malignancy; therefore he underwent endoscopic treatment with TUR-P. Histopathological examination reported BPH. The postoperative 1-year follow-up was uneventful. DISCUSSION The patient was extensively evaluated with a suspicion of malignancy, especially rhabdomyosarcoma, which is more expected for this age group. Reviewing juvenile cases with BPH in the literature, two authors explained the possible etiologic factors of their cases as gonadotropin supplement therapy for undescended testes and the mother's utilization of a human chorionic gonadotropin-containing agent during pregnancy to prevent spontaneous abortion. Our case had no history of drug intake, endocrinologic abnormality, or any other possible relevant factor. Owing to the limited number of cases, there is not enough data to understand the etiology and also no consensus on the treatment of BPH in the adolescents. Therefore, experiences gained from adult cases guide the pediatric treatment modalities. CONCLUSION Despite the fact that BPH is very rare in childhood, one should keep it in mind in the differential diagnosis of acute urinary retention and malignant prostate diseases. The endoscopic method is the treatment of choice in BPH.
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Affiliation(s)
- Ismail Yağmur
- Department of Pediatric Surgery, Division of Pediatric Urology, Ege University, Izmir, Turkey.
| | - Burak Turna
- Department of Urology, Ege University, Izmir, Turkey
| | - Ali Tekin
- Department of Pediatric Surgery, Division of Pediatric Urology, Ege University, Izmir, Turkey
| | | | - Bnu Sarsık
- Department of Pathology, Ege University, Turkey
| | - İbrahim Ulman
- Department of Pediatric Surgery, Division of Pediatric Urology, Ege University, Izmir, Turkey
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Löllgen RM, Sabo J, Mettler A, Liniger B, Berger S. Unique Presentation of Hematometrocolpos Mimicking Cauda Equina Syndrome: Severe Back Pain and Urinary Incontinence in an Adolescent Girl. J Emerg Med 2016; 51:e19-23. [DOI: 10.1016/j.jemermed.2016.01.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Revised: 12/16/2015] [Accepted: 01/22/2016] [Indexed: 12/18/2022]
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Traslaviña GAA, Del Ciampo LA, Ferraz IS. [Acute urinary retention in a pre-school girl with constipation]. REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2015; 33:488-92. [PMID: 26298658 PMCID: PMC4685571 DOI: 10.1016/j.rpped.2015.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 03/05/2015] [Accepted: 03/05/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To report a case of a preschool girl who developed acute urinary retention associated with constipation. CASE DESCRIPTION A girl aged six years old presented a 24 hour history of inability to urinate. She was went twice to the emergency room during this period. In the first admission, 12 hours after the onset of the symptoms, she presented abdominal pain and acute urinary retention. After the drainage by urinary catheterization of 300 mL of clear urine, she presented relief of the symptoms and, as urinalysis had no change, the patient was discharged home. Twelve hours after the first visit, she returned to the emergency room complaining about the same symptoms. At physical examination, there was only a palpable and distended bladder up to the umbilicus with no other abnormalities. Again, a urinary catheterization was performed, which drained 450 mL of clear urine, with immediate relief of the symptoms. Urinalysis and urine culture had no abnormalities. During the anamnesis, the diagnosis of constipation was considered and a plain abdominal radiography was performed, which identified large amount of feces throughout the colon (fecal retention). An enema with a 12% glycerin solution was prescribed for three days. During follow-up, the child used laxatives and dietary modifications, this contributed to the resolution of the constipation. There were no other episodes of urinary retention after 6 months of follow-up. COMMENTS Acute urinary retention in children is a rare phenomenon and constipation should be considered as a cause.
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Affiliation(s)
- Guillermo A Ariza Traslaviña
- Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brasil
| | - Luiz Antonio Del Ciampo
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brasil.
| | - Ivan Savioli Ferraz
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brasil
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