Rigonalli Ursina, Sigg Silvan, Moos Seraina Von, Baumeister Philipp, Mattei Agostino, Fankhauser Christian D, Affentranger Andres
Cantonal Hospital of Lucerne, Lucerne, Switzerland.
University of Lucerne, Lucerne, Switzerland.
Eur Urol Open Sci. 2025 Feb 18;73:68-70. doi: 10.1016/j.euros.2025.01.017. eCollection 2025 Mar.
Urinary retention is a common urological emergency requiring catheterization. However, follow-up management remains poorly defined, particularly regarding post-obstruction hyperdiuresis (POHD), which may lead to complications such as hypovolemia and electrolyte disturbances. Our mini review of PODS identified nine relevant studies involving 665 patients. POHD occurred in 15-78% of cases, with a mean duration of 2-5 d. Risk factors included serum creatinine >105 μmol/l (odds ratio [OR] 4.83, 95% confidence interval [CI] 1.14-20.44; = 0.032) and greater bladder volume (OR per 100-ml increment: 1.21, 95% CI 1.06-1.40; = 0.006). Complications included hematuria (11-55%), hyponatremia (22-28%), and hypotension (9%), most of which were self-limiting. Data on management were sparse; one randomized controlled trial showed no significant difference in complications between rapid and gradual decompression. The lack of standardized protocols underscores the need for further prospective studies to optimize patient outcomes.
After relief of urinary obstruction, an increase in urination is common. Complications such as blood in the urine, electrolyte imbalances, and dehydration may occur but typically resolve on their own without additional treatment.
尿潴留是一种常见的需要导尿的泌尿外科急症。然而,后续管理仍不明确,尤其是关于梗阻后利尿(POHD),这可能导致诸如血容量不足和电解质紊乱等并发症。我们对POHD的小型综述确定了9项涉及665例患者的相关研究。POHD发生在15%至78%的病例中,平均持续时间为2至5天。危险因素包括血清肌酐>105μmol/L(比值比[OR]4.83,95%置信区间[CI]1.14至20.44;P = 0.032)和膀胱容量更大(每增加100 ml的OR:1.21,95%CI 1.06至1.40;P = 0.006)。并发症包括血尿(11%至55%)、低钠血症(22%至28%)和低血压(9%),其中大多数是自限性的。关于管理的数据很少;一项随机对照试验表明,快速减压和逐渐减压在并发症方面没有显著差异。缺乏标准化方案凸显了进一步进行前瞻性研究以优化患者预后的必要性。
解除尿路梗阻后,尿量增加很常见。可能会出现血尿、电解质失衡和脱水等并发症,但通常无需额外治疗即可自行缓解。