usmleasr
Forum Guru
Topics: 105
Posts: 970
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in case of post operative urinary retention...which one do u prefer,
intermittent catheterization
or catheter left in bladder?
please explain the ans :roll:
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| asmi
Forum Hero
Topics: 1043
Posts: 4,609
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i think intermittent catherization will help...to train the bladder...to behave normally
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| premonition
Forum Elite
Topics: 48
Posts: 192
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Intermittent Catheterisation.
Same reason as above.
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Of all the things I have lost,I miss my mind the most.
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| usmle_stp2
Forum Newbie
Topics: 1
Posts: 11
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For postop urinary retension, I think the answer is
Catheter left in bladder atleast for 48hrs.
Reason
1. Depends on the surgery. If there is lot of dissection around the bladder, urinary retention can develop.
2. Rarely preanaesthetic medications like anticholinergics can also cause urinnary retention.
Bladder tone will usually take several hours to return especially if there was lot of dissection around the bladder. There is every chance that it can get distented again if catheter is removed prematurely. So, give enough time for the bladder to regain its tone before removing the catheter be it the first time you are removing the catheter after the surgery or you happen to recatheterise because patient is not able to urinate after the initial removal of catheter postoperatively. You can always send a sample of urine for culture to rule out any infection.
More over intermittent catheterisation is not recommended as it increases the chances of infection.
This is my thinking. Please correct me if I am wrong.
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| son64
Forum Elite
Topics: 34
Posts: 245
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For post op retention you do in and out catheterization then you observe the patient.If still not passing urine do it again and observe.If still not passing you insert indwellig catheter.Some say indwelling catheter has to be inserted on the second trial.
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| usmleasr
Forum Guru
Topics: 105
Posts: 970
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hi ,
thanks all of u for good explanations.. i asked this q becos..kaplan q book there is a q , ans saying it is in and out catheterization ..and kaplan text surgery says it is indwelling catheter...
usmlestep_2 ur explanationis good ..but one change..it is indwelling catheter that increases chance of infection...
son 64 , ur explanation appears more practical...
i will go for in and catheterization first may be..  ...add few other references as u come across
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| Anil Kumar980
Forum Senior
Topics: 15
Posts: 130
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Actually it depends on the surgery.If its around the bladder then you know there will be retention.So you leave a catheter before there is retention
In others,you can wait for passage of urine and if there is bladder distension,U go for in n out catheter.Till here everyone feels the same But now on,some advocate Foleys for 2nd retention and others prefer in and out even for 2nd and go for foleys durin the 3rd.
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