management
Last reviewed 06/2023
The first objective is to relieve the patient of the discomfort so provide some strong opiate analgesia. Try conservative methods first - privacy, sound of running water, and making the patient stand up.
Catheterise if these conservative methods do not provide relief. First, try a Foley catheter inserted via the urethra; if unsuccessful, try a suprapubic catheter.
Some factors that should discourage an attempt at simple urethral catherisation include:
- previous prostatectomy
- known urethral stricture
- history of difficult catheterisation
- non-retractile foreskin
NICE have suggested guidance regarding the management of acute urinary retention in an adult male (1):
- immediately catheterise men with acute retention
- offer an alpha blocker to men for managing acute urinary retention before removal of the catheter
Reference:
antibiotics and catheter management