AUA: Managing Nonneurogenic Chronic Urinary Retention
High risk chronic urinary retention was defined as hydronephrosis on imaging, stage 3 chronic kidney disease or recurrent culture proven urinary tract infection or urosepsis.
(HealthDay News) — A white paper has been developed by the American Urological Association Quality Improvement and Patient Safety committee with respect to the diagnosis and management of nonneurogenic chronic urinary retention; the paper was published in the July issue of The Journal of Urology.
John T. Stoffel, MD, from the University of Ann Arbor in Michigan, and colleagues created a white paper on the diagnosis and management of nonneurogenic chronic urinary retention based on a review of the literature and consensus expert opinion from a workgroup.
The researchers note that nonneurogenic chronic urinary retention was defined by the workgroup as an elevated post-void residual of more than 300 mL, which persisted for at least 6 months and was documented on at least 2 separate occasions. They proposed that chronic urinary retention should be classified by risk and symptomatology. They also proposed a treatment algorithm based on stratification of patients by risk then by symptoms. To determine effectiveness of retention treatment, the primary outcomes that should be assessed are: symptom improvement, risk reduction, successful trial of voiding without catheterization, and stability of symptoms and risk over time.
"Defining and categorizing nonneurogenic chronic urinary retention, creating a treatment algorithm, and proposing treatment end points will hopefully spur comparative research that will ultimately lead to a better understanding of this challenging condition," the authors write.
- Stoffel JT, Peterson AC, Sandhu JS, et al. AUA White Paper on Nonneurogenic Chronic Urinary Retention: Consensus Definition, Treatment Algorithm, and Outcome End Points. J Urol. July 2017. doi: 10.1016/j.juro.2017.01.075