title: Postobstructive diuresis: pay close attention to urinary retention.
abstract: OBJECTIVE
  To educate primary health care professionals about the diagnosis and treatment of postobstructive diuresis (POD), a rare but potentially lethal complication associated with the relief of urinary obstructions.
  
  
  METHODS
  The main concepts and clinical evidence reviewed in this article were derived from a literature search of PubMed and Google Scholar. Expert opinion was used to supplement recommendations in areas with little evidence.
  
  
  RESULTS
  Urinary retention is a frequently encountered presentation seen by all physicians. Most family physicians are comfortable treating these patients, initiating investigations, and organizing appropriate follow-up. This article reviews a rare but potentially lethal complication known as POD. Postobstructive diuresis is a polyuric response initiated by the kidneys after the relief of a substantial bladder outlet obstruction. In severe cases this condition can become pathologic, resulting in dehydration, electrolyte imbalances, and death if not adequately treated. Primary care physicians should be familiar with this potential clinical entity, especially as they are generally the first to encounter and treat these patients.
  
  
  CONCLUSIONS
  Physicians aware of POD will be able to identify patients at risk and arrange the appropriate monitoring after relieving a urinary obstruction. Early diagnosis and treatment of pathologic POD will prevent mortality.
authors.forename: Colin
authors.initials: C
authors.lastname: Halbgewachs
authors.forename: Trustin
authors.initials: T
authors.lastname: Domes
mesh_terms: D003681:Dehydration / Q000209:etiology; D004231:Diuresis; D005194:Family Practice / Q000379:methods; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D058007:Physicians, Primary Care / Q000193:education*; D011141:Polyuria / Q000150:complications* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D016055:Urinary Retention / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D014882:Water-Electrolyte Balance
references.citation: J Clin Invest. 1976 Jun;57(6):1564-74
references.pmid: 932194
references.citation: J Urol. 1975 Jul;114(1):53-6
references.pmid: 1142500
references.citation: J Urol. 1973 Feb;109(2):286-92
references.pmid: 4119598
references.citation: Rehabil Nurs. 2001 Sep-Oct;26(5):187-91
references.pmid: 12035688
references.citation: J Urol. 1984 Mar;131(3):534-6
references.pmid: 6699999
references.citation: Br Med J (Clin Res Ed). 1984 Sep 1;289(6444):515-6
references.pmid: 6432169
references.citation: Br J Urol. 1985 Feb;57(1):1-5
references.pmid: 3971092
references.citation: Br J Urol. 1991 Mar;67(3):280-5
references.pmid: 2021816
references.citation: Mayo Clin Proc. 1997 Oct;72(10):951-6
references.pmid: 9379700
references.citation: J Urol. 2008 Jul;180(1):47-54
references.pmid: 18485378
references.citation: BJU Int. 2012 Dec;110(11 Pt C):E1027-34
references.pmid: 22583774
references.citation: Trop Doct. 2013 Jan;43(1):13-6
references.pmid: 23443627
references.citation: Intern Med. 2000 May;39(5):355-61
references.pmid: 10830173
references.citation: Br Med J. 1978 Nov 4;2(6147):1258-60
references.pmid: 709305