Marshall John R, Haber Jordana, Josephson Elaine B
Emerg Med Pract. 2014 Jan;16(1):1-20; quiz 21.
Approximately 10% of men in their 70s and 33% of men in their 80s report at least 1 episode of acute urinary retention, and this urological emergency presents unique assessment and treatment challenges in the emergency department setting. Patients presenting with acute urinary retention are often in severe pain and require urgent diagnosis and prompt treatment. The differential diagnosis of acute urinary retention is vast, with some causes leading to permanent impairment if not dealt with in a timely manner. Quick recognition of the cause and timely bladder decompression are of utmost importance in preventing morbidity and relieving pain. This review analyzes the etiology, key historical and physical findings, differential diagnosis, and diagnostic studies for acute urinary retention in both men and women. Treatment algorithms for men and women, current controversies regarding urinary catheter usage, and recommendations on criteria for disposition are also presented.
大约10%的70多岁男性和33%的80多岁男性报告至少发生过1次急性尿潴留，这种泌尿系统急症在急诊科环境中带来了独特的评估和治疗挑战。出现急性尿潴留的患者通常疼痛剧烈，需要紧急诊断和及时治疗。急性尿潴留的鉴别诊断范围很广，有些病因如果不及时处理会导致永久性损伤。快速识别病因并及时解除膀胱梗阻对于预防发病和缓解疼痛至关重要。本综述分析了男性和女性急性尿潴留的病因、关键的病史和体格检查结果、鉴别诊断以及诊断研究。还介绍了男性和女性的治疗方案、目前关于导尿管使用的争议以及处置标准的建议。
