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Question 7#

 Treatment of acute urinary retention may include all of the following EXCEPT:

A. Coude catheterization
B. Fluid replacement using 1:1 mL of D5W
C. Placement of a suprapubic drainage tube
D. Continuous bladder irrigation if hematuria is the cause of retention

Correct Answer is B

Comment:

Treatment should include placement of a urethral catheter as quickly as possible. However, benign prostatic hyperplasia (BPH) or urethral strictures often make the placement of a catheter difficult. For men with BPH, a coude (French for curved) catheter is helpful in negotiating past the angulation in the prostatic urethra. Placement of a suprapubic tube approximately two fingerbreadths above the pubic symphysis may be needed. If hematuria is the cause of retention, continuous bladder irrigation often is necessary to prevent clot formation. Fluid replacement typically is 0.5 mL of 0.45 normal saline for every 1 mL of urine output above 200 mL in 1 hour, although sodium and potassium supplementation requirements depend on the electrolyte status of the patient.