Listening to the July issue of the abstracts there was talk of when to remove the catheter after urinary retention.
Where I’ve practiced we’ve always left the catheter in after urinary retention and they (when they don’t get lost in the system) get follow up with urology and hopefully get a trial removal some time later. They also get an alpha blocker
Dr Hoffman suggests that 2/3 will do OK if we take the catheter out in the ED after we’ve relieved the urinary retention.
If it really is 2/3 then I think I’ll at least start giving patients the option of removal in the ED. My suspicion is lots of patients will be happy to go home without a catheter.
Of note they talked about this best bet in the EMJ. It seems alpha blockers probably help a bit but might be problematic with postural low BP in the elderly people who tend to get retention.
Towards evidence-based emergency medicine: best BETs from the Manchester Royal Infirmary. BET 1. Alpha-blockers increase the chances of a successful trial without catheter after acute urinary retention. Emerg Med J. 2011 Feb;28(2):161-5. PMID 21239423
What are other people doing with the catheters?
My favorite anecdote on retention: I saw an old guy with prostatism who decided to improve his flow by taking his wifes Lasix! He had 2 liters in the bag after idc
I remember as an intern being called to see a guy with no urine output for a fee hours and gave him some lasix. An hour later there was still no output and I flushed the catheter and a now mighty river of urine was unleashed!