POSTOBSTRUCTIVE DIURESIS

Course overview

URINARY RETENTION IS A RELATIVELY COMMON UROLOGICAL PROBLEM ENCOUNTERED IN BOTH INPATIENT AND OUTPATIENT SETTINGS. IT SHOULD BE HIGH ON THE DIFFERENTIAL DIAGNOSIS OF ANY PATIENT WITH LOWER ABDOMINAL DISCOMFORT AND URINARY SYMPTOMS. RETENTION CAN BE CONFIRMED WITH A POST-VOID RESIDUAL VOLUME DETERMINATION EITHER WITH A BLADDER ULTRASOUND OR VIA CATHETERIZATION. POST-OBSTRUCTIVE DIURESIS CAN OCCUR AFTER THE ACUTE DRAINAGE AND DECOMPRESSION OF A DISTENDED BLADDER AND RESULTS IN PROLONGED POLYURIA WITH EXCESSIVE LOSS OF BOTH SALT AND WATER. NORMAL MAXIMUM BLADDER CAPACITY IS ABOUT 450 TO 500 CUBIC CENTIMETERS. POST-OBSTRUCTIVE DIURESIS IS NOT TYPICALLY A CONCERN UNLESS THE POST-VOID RESIDUAL VOLUME IS GREATER THAN OR EQUAL TO 1,500 CUBIC CENTIMETERS. POST-OBSTRUCTIVE DIURESIS CAN CAUSE SERIOUS CONSEQUENCES SUCH AS DEHYDRATION, ELECTROLYTE ABNORMALITIES, HYPOTENSION, HYPOVOLEMIC SHOCK, AND EVEN RESULT IN DEATH. THIS ACTIVITY REVIEWS THE EVALUATION AND MANAGEMENT OF POST-OBSTRUCTIVE DIURESIS AND HIGHLIGHTS THE ROLE OF INTERPROFESSIONAL TEAM MEMBERS IN COLLABORATING TO PROVIDE WELL-COORDINATED CARE AND ENHANCE OUTCOMES FOR AFFECTED PATIENTS.