Urinary Retention After Removal of Foley Catheter

David Ginsberg, MD

Disclosures

March 03, 2005

Question

Several female patients of mine have experienced urinary retention after the removal of a Foley catheter. Is the cause usually urethral edema? If so, is there any evidence that urecholine, pyridium, NSAIDs, or other drug treatment can help restore flow?

Jeff Mack, MD

Response from David Ginsberg, MD

This is an interesting problem. There is often no obvious reason why women experience urinary retention after the removal of a catheter. I've noticed this more in elderly patients and have always wondered whether it was simply due to age. An older bladder has decreased detrusor contractility; perhaps it is not able to generate enough force once the catheter is removed. This condition usually gets better with time; the problem is what to do in the meantime if the patient is unable to void sufficiently on her own. Unfortunately, the treatment options are limited These include intermittent catheterization (which many older patients have trouble learning to do) or replacement of the indwelling catheter. Another option is teaching a family member or attendant to do intermittent catheterization. I tend to use alpha-blockers for these patients. Alpha-blockers have only been evaluated for the therapy of bladder outlet obstruction in men secondary to prostatic obstruction, but they clearly help open the outlet at the level of the bladder neck in both sexes. I do believe it helps women in the situation you described.

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