Document Detail

Urinary retention in women and sacral neuromodulation.
MedLine Citation:
PMID:  20972545     Owner:  NLM     Status:  MEDLINE    
The remit of this article is to provide an overview of urinary retention in women, taking into account the predisposing factors, aetiology, investigations and treatments. The information presented is based on a widespread search of the English literature using multiple library sites on the internet and on personal experience. Urinary retention occurs when there is impaired bladder emptying, resulting in a high post-void urinary residual. It is often associated with restricted voiding. The aetiology is manifold and thus the symptomatic patient may present to the urologist, gynaecologist, neurologist or physician. Once the problem is identified, and predisposing factors excluded (e.g. opiates), the patient has to be investigated fully. In the Department of Uro-Neurology at the National Hospital for Neurology and Neurosurgery in the UK, we advocate the use of urethral sphincter assessments, including urethral pressure studies, ultrasound volume assessment and electromyography. This article will take a detailed look at all aspects of assessing these patients. In those in whom diagnosis is reached, sacral neuromodulation (SNM) is the treatment of choice. As a modality, SNM has its supporters but also its detractors. Thus, it is essential that all patients are fully counselled before undergoing this surgery. Urinary retention in women is still poorly understood. This article serves to demystify the issues raised in having this condition, by looking closely at the currently known science. It is clear that some patients may be diagnosed with Fowler's syndrome and may thus be more treatable by SNM than others, but this still leaves a significant proportion of patients with no diagnosis and no satisfactory therapy. A great deal of work still needs to be done on the understanding of the pathogenesis, the provision of more distinct investigations and the development of better treatment modalities.
Sohier Elneil
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  International urogynecology journal     Volume:  21 Suppl 2     ISSN:  1433-3023     ISO Abbreviation:  Int Urogynecol J     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-10     Completed Date:  2011-03-02     Revised Date:  2011-08-18    
Medline Journal Info:
Nlm Unique ID:  101567041     Medline TA:  Int Urogynecol J     Country:  England    
Other Details:
Languages:  eng     Pagination:  S475-83     Citation Subset:  IM    
Department of Uro-Neurology, National Hospital for Neurology and Neurosurgery, London, UK.
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MeSH Terms
Electric Stimulation Therapy / methods*
Implantable Neurostimulators
Spinal Nerve Roots*
Treatment Outcome
Urinary Retention / physiopathology*,  therapy*

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