Mevcha Amit, Drake Marcus J
Bristol Urological Institute, Southmead Hospital, Bristol, BS10 5NB, UK.
Indian J Urol. 2010 Apr;26(2):230-5. doi: 10.4103/0970-1591.65396.
Urinary retention (UR) can be defined as inability to achieve complete bladder emptying by voluntary micturition, and categorized as acute UR, chronic UR or incomplete bladder emptying. UR is common in elderly men but symptomatic UR is unusual in women. The epidemiology of female UR is not well documented. There are numerous causes now recognized in women, broadly categorized as infective, pharmacological, neurological, anatomical, myopathic and functional; labeling symptoms as having a "psychogenic basis" should be avoided. Detrusor failure is often an underlying factor that complicates interpretation. Initial management includes bladder drainage (intermittent or indwelling catheterization) if the woman is symptomatic or at risk of complications, and correcting likely causes. Investigations should be focused on identifying the underlying etiology and any reversible factor. A detailed history, general and pelvic examination are needed; urine dipstick analysis, routine microscopy and culture, and pelvic and renal ultrasound are suitable baseline investigations. Urodynamic tests are required in specific situations. Urethral dilatation has a limited role, but it should be considered if there is urethral stenosis. Definitive management requires correction of cause where possible and symptom management where no correctable cause is detected. Follow-up is needed for monitoring response to treatment, detection of complications and symptom control. Fowler's syndrome is a specific group diagnosed on urethral sphincter electromyogram, representing a very challenging clinical scenario.
尿潴留（UR）可定义为无法通过自主排尿实现膀胱完全排空，并可分为急性尿潴留、慢性尿潴留或膀胱排空不全。尿潴留在老年男性中很常见，但有症状的尿潴留在女性中并不常见。女性尿潴留的流行病学资料记载不足。目前已认识到女性尿潴留的原因众多，大致可分为感染性、药物性、神经性、解剖性、肌病性和功能性；应避免将症状标记为具有“心理源性基础”。逼尿肌功能障碍往往是一个使解释复杂化的潜在因素。初始治疗包括如果女性有症状或有并发症风险则进行膀胱引流（间歇性或留置导尿），并纠正可能的病因。检查应侧重于确定潜在病因和任何可逆因素。需要详细的病史、全身和盆腔检查；尿试纸分析、常规显微镜检查和培养以及盆腔和肾脏超声是合适的基线检查。在特定情况下需要进行尿动力学检查。尿道扩张的作用有限，但如果存在尿道狭窄则应考虑。明确的治疗需要尽可能纠正病因，在未检测到可纠正病因的情况下进行症状管理。需要进行随访以监测治疗反应、检测并发症和控制症状。福勒综合征是一组根据尿道括约肌肌电图诊断的特定病例，代表了一种极具挑战性的临床情况。
