Surgical management of non-obstructive urinary retention.
Non-obstructive urinary retention is a complex disorder that can pose diagnostic and therapeutic problems to the treating urologist. A through history and physical examination coupled with well performed and interpreted urodynamic testing can offer insight into the etiology and prognosis of the disease. Myriad pharmacologic and conservative therapies exist to treat non-obstructive retention but success is limited. The majority of patients with non-obstructive retention are consigned to long-term bladder decompression with the preponderance of evidence-based studies supporting clean intermittent catheterization. Surgical treatment is essentially limited to sacral nerve stimulation. Published data cites success rates with sacral nerve stimulation approaching 80% with a catheterization-free rate of close to 50%. And while future study is needed to refine and identify which patients will benefit the most, the profound improvement afforded by sacral nerve stimulation makes it the treatment of choice for patients with otherwise refractory non-obstructive retention.
White
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WH
Division of Urologic Surgery, Section of Neuro-Urology and Voiding Dysfunction, University of Tennessee Medical Center, 1924 Alcoa Highway, Knoxville, TN 37920, USA. wwhite@mc.utmck.edu
Doggweiler
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R
Klein
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FA
D006801:Humans; D008875:Middle Aged; D016055:Urinary Retention / Q000209:etiology / Q000601:surgery* / Q000628:therapy