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Zeba A, Ashraf K, Krishnan K, Shabbir A, Chinnakaruppan S. Acute Urinary Retention Due to Incarcerated Uterus With Adenomyosis: A Case Report. Cureus 2024; 16:e63170. [PMID: 39070343 PMCID: PMC11273072 DOI: 10.7759/cureus.63170] [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] [Accepted: 06/25/2024] [Indexed: 07/30/2024] Open
Abstract
Acute urinary retention caused by uterine incarceration due to adenomyosis is a rare phenomenon with limited documented cases. This report details the case of a 38-year-old female with acute urinary retention. A pelvic MRI revealed an enlarged retroverted uterus with a mass on the posterior left of the myometrium, indicative of adenomyosis. The size and anatomical location of the mass suggested uterine incarceration with direct pressure on the urinary bladder neck, leading to urinary retention. The patient underwent total abdominal hysterectomy, bilateral salpingectomy, and adhesiolysis. Subsequent follow-ups at one and three months post-surgery showed the resolution of urinary symptoms, underscoring the importance of considering adenomyosis as a potential cause of urinary retention in women with lower urinary tract symptoms. Timely recognition and appropriate intervention are crucial for mitigating complications and improving outcomes in these patients, as illustrated in this case.
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Affiliation(s)
- Aalami Zeba
- Obstetrics and Gynaecology, Hamad General Hospital, Al Khor, QAT
| | - Khadija Ashraf
- Obstetrics and Gynaecology, Hamad Medical Corporation, Al Khor, QAT
| | - Kavitha Krishnan
- Obstetrics and Gynaecology, Hamad Medical Corporation, Al Khor, QAT
| | - Azhar Shabbir
- General Surgery, Hamad Medical Corporation, Doha, QAT
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Motamed C. Clinical Update on Patient-Controlled Analgesia for Acute Postoperative Pain. PHARMACY 2022; 10:pharmacy10010022. [PMID: 35202071 PMCID: PMC8877436 DOI: 10.3390/pharmacy10010022] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 01/20/2022] [Accepted: 01/25/2022] [Indexed: 02/06/2023] Open
Abstract
Patient-controlled analgesia (PCA) is an effective method for controlling acute pain, including postoperative pain in adults and in children from five years of age, pain resulting from labor, trauma, or other medical situations, or chronic and malignant pain. The treatment consists of a mini-computer-controlled infusion pump permitting the administration of on-demand, continuous, or combined doses of analgesic (mainly opioid) variations in response to therapy, which allows pain to be significantly controlled. Intravenous (IV)-PCA minimizes individual pharmacodynamics and pharmacokinetic differences and is widely accepted as a reference method for mild or severe postoperative pain. IV-PCA is the most studied route of PCA; other delivery methods have been extensively reported in the literature. In addition, IV-PCA usually voids the gap between pain sensation and analgesic administration, permitting better recovery and fewer side effects. The most commonly observed complications are nausea and vomiting, pruritus, respiratory depression, sedation, confusion and urinary retention. However, human factors such as pharmacy preparation and device programming can also be involved in the occurrence of these complications, while device failure is much less of an issue.
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Affiliation(s)
- Cyrus Motamed
- Department of anesthesia, Gustave Roussy Cancer Campus, 94080 Villejuif, France
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Jang YK, Kim NY, Lee JS, Shin HJ, Kim HG, Lee SW, Koh JC, Yoo YC. Comparison of Postoperative Pain and Adverse Effects between Variable-Rate Feedback Infusion and Conventional Fixed-Rate Basal Infusion Modes of Patient-Controlled Epidural Analgesia following Open Gastrectomy: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168777. [PMID: 34444526 PMCID: PMC8391703 DOI: 10.3390/ijerph18168777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 08/10/2021] [Accepted: 08/15/2021] [Indexed: 11/16/2022]
Abstract
Patient-controlled epidural analgesia is widely used to control postoperative pain following major intra-abdominal surgeries. However, determining the optimal infusion dose that can produce effective analgesia while reducing side effects remains a task to be solved. Postoperative pain and adverse effects between variable-rate feedback infusion (VFIM group, n = 36) and conventional fixed-rate basal infusion (CFIM group, n = 36) of fentanyl/ropivacaine-based patient-controlled epidural analgesia were evaluated. In the CFIM group, the basal infusion rate was fixed (5 mL/h), whereas, in the VFIM group, the basal infusion rate was increased by 0.5 mL/h each time a bolus dose was administered and decreased by 0.3 mL/h when a bolus dose was not administered for 2 h. Patients in the VFIM group experienced significantly less pain at one to six hours after surgery than those in the CFIM group. Further, the number of patients who suffered from postoperative nausea was significantly lower in the VFIM group than in the CFIM group until six hours after surgery. The variable-rate feedback infusion mode of patient-controlled epidural analgesia may provide better analgesia accompanied with significantly less nausea in the early postoperative period than the conventional fixed-rate basal infusion mode following open gastrectomy.
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Affiliation(s)
- Yoo Kyung Jang
- Department of Anesthesiology and Pain Medicine, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Korea; (Y.K.J.); (H.G.K.); (S.W.L.)
| | - Na Young Kim
- Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea; (N.Y.K.); (J.S.L.)
| | - Jeong Soo Lee
- Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea; (N.Y.K.); (J.S.L.)
| | - Hye Jung Shin
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea;
| | - Hyoung Gyun Kim
- Department of Anesthesiology and Pain Medicine, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Korea; (Y.K.J.); (H.G.K.); (S.W.L.)
| | - Suk Woo Lee
- Department of Anesthesiology and Pain Medicine, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Korea; (Y.K.J.); (H.G.K.); (S.W.L.)
| | - Jae Chul Koh
- Department of Anesthesiology and Pain Medicine, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Korea; (Y.K.J.); (H.G.K.); (S.W.L.)
- Correspondence: (J.C.K.); (Y.C.Y.); Tel.: +82-920-5632 (J.C.K.); +82-2228-4435 (Y.C.Y.)
| | - Young Chul Yoo
- Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea; (N.Y.K.); (J.S.L.)
- Correspondence: (J.C.K.); (Y.C.Y.); Tel.: +82-920-5632 (J.C.K.); +82-2228-4435 (Y.C.Y.)
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