Authors (including presenting author) :
Lam WS, Wong YM, Wong SW, Chung YY
Affiliation :
Continence Care Service, United Christian Hospital, Kowloon East Cluster
Introduction :
Acute retention of urine (AROU) is the inability to void urine voluntarily. It is an emergency condition and requires bladder catheterization. Causes of retention of urine are numerous such as obstructive, infectious, pharmacologic, neurologic and others like constipation. Inpatients with Foley catheter in-situ may require longer hospitalization. In order to facilitate early discharge and decrease length of stay, continence nurses provide inpatient ward consultation within 24 hours after receiving referral. Continence nurses also provide comprehensive assessment, physical examination in order to determine the possible causes of retention of urine and plan tailor-made nursing management.
Objectives :
(a) To identify the etiology of acute retention of urine
(b) To provide tailor-made nursing management
(c) To minimize unnecessary Foley catheter
(d) To increase patient’s quality of life
(e) To decrease length of stay and encourage early discharge
Methodology :
Retrospective study was done to review the cause of AROU, TWOC episodes and management outcomes. The data was obtained from TKO in-patient consultation note from 1 Oct 2021 to 30 Sept 2022.
Result & Outcome :
60 inpatients (Female:45, Male:15) with AROU were reviewed. The mean age was 77.7. 97 % of the patients were referred from Medical wards. 54% Patients developed AROU mainly from Day 0 to day 2 since admission. Higher successful rate for TWOC was on the 2nd and 3rd times of TWOC ( from 17-26.6 days) despite 93.3% of patient was being TWOC on day 9.1 since admission with 95% failed to wean off Foley catheter. Therefore recommendation for TWOC on Day 17 after AROU or afterwards allowed sufficient time to treat the underlying causes in order to achieve better outcome e.g. bowel or fluid intake management, mobility or infection management. 50% of inpatients with AxR done with moderate to severe fecal loaded. 40% of inpatients were prescribed laxative prn or without laxative prescribed. It was suggested that AXR was an important investigation for bowel screening of AROU patients as constipation was one of the most common causes of AROU. Using regular laxatives can relieve constipation associated with AROU. Furthermore, TWOC after completion the course of antibiotics one day or afterward was preferable to achieve higher rate of successful of TWOC.
