Retention in an older man on a medical ward is often precipitated by something treatable on top of prostatic enlargement. Constipation, anticholinergic drugs, opioids, recent anaesthesia, immobility and infection are the common ones.
Review the drug chart, examine for faecal loading and check for infection before planning the trial without catheter. Removing the trigger is as important as the catheter itself.
- Review the drug chart for anticholinergics, opioids, antihistamines and tricyclic antidepressants.
- Treat constipation before a trial without catheter.
- Record the drained volume; it guides urology referral.
- Check kidney function after catheterisation for obstructive injury.
Why it matters
A trial without catheter is more likely to fail if the trigger that caused retention is still present.
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