Audit of inpatient chronic urinary retention management

Abstract

BACKGROUND: Chronic urinary retention (CUR) occurs when urine accumulates in the bladder secondary to incomplete voiding. The aim of this audit was to assess compliance to the Mater Dei Hospital Urinary Retention Management Guidelines in a cohort of patients admitted between August 2019 and February 2020.

METHODOLOGY: Patients admitted because of CUR were included. Data was acquired from medical files, discharge letters, hospital electronic record systems and urology outreach records.

STANDARD USED: The Urinary Retention Management Guidelines, published in 2018, were considered standard for outcome comparison.

RESULTS: The quantitative results included data on clinical presentation, inpatient management and medium-term outcomes. 55% had a successful TWOC after CUR. 45% were treated pharmacologically, 35% had a trans-urethral resection of the prostate, 10% started a self-intermittent catheterisation (SIC) programme, 5% remained with a long-term catheter and 5% required a re-trial without catheter (TWOC).

CONCLUSION: Compliance to MDH guidelines was suboptimal in some cases. This audit highlights CUR management issues which can be optimised and also current outcomes of patients presenting in CUR. 55% of patients presented with a degree of acute kidney injury. Nephrology specialists were rarely involved in the management of these patients.