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Lower urinary tract symptoms in men, age-related (including symptoms of benign prostatic hyperplasia/hypertrophy) - Management
How do I manage acute urinary retention in a man?
- If this is the first episode of acute urinary retention:
- Admit the man urgently for catheterization and investigation of the cause.
- If the expertise and facilities are available, catheterize before admission.
- For an episode of recurrent acute retention, or acute-on-chronic urinary retention:
- Admit the man, or insert a urethral catheter. Discuss and decide on treatment to prevent or manage recurrent urine retention. Options include:
- An alpha-blocker (alfuzosin) — start at least 24 hours before attempting to remove the catheter. After removing the catheter, confirm over several hours that the man can void freely. Continue the alpha-blocker until the man has been fully investigated to determine the cause and to assess renal function. For detailed prescribing information, see Alpha-blockers for voiding symptoms.
- Intermittent urethral catheterization — refer the man or his carer to a continence nurse for training in catheterization.
- A long-term indwelling catheter — only if intermittent catheterization is not appropriate or practical.
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