URINARY RETENTION

URINARY RETENTION

Urinary retention is defined as the inability to pass urine despite persistent e ff ort. It can be classified as acute (painful inability to pass urine with relief of pain on catheterisation) or chronic (painless, elevated residual volume after passing urine). The causes of urinary retention in men and women are given in Table 83.9 . Heinrich Martius , 1885–1965, German surgeon, described a labial flap of bulbocavernosus muscle (Martius modified labial fat pad) in 1928. Clare Juliet Fowler , contemporary , Professor of Uroneurology , National Hospital for Neurology and Neurosurgery , London, UK. /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF Summary box 83.4 Urinary tract fistulae /uni25CF /uni25CF /uni25CF /uni25CF

Women Urethral Stricture Diverticulum Meatal stenosis Carcinoma Prolapse Extrinsic compression Paraurethral cyst Pelvic mass (e.g. large /f_i broids) Gynaecological malignancy Iatrogenic Anti-incontinence surgery Urethral reconstruction Idiopathic high-tone non-relaxing external urethral sphincter (Fowler’s syndrome) Dysfunctional voiding Primary bladder neck obstruction The principles of surgical repair of VVF are: Adequate exposure of the /f_i stula tract Tension-free, watertight, multilayer closure with non- overlapping suture lines Interposition with a well-vascularised /f_l ap Urinary tract drainage postoperatively to allow healing