Show notes
Your postoperative patient has not urinated in six hours. Is the bladder full—or are the kidneys simply not making urine? That distinction is the key to getting postoperative urinary retention questions right on the Surgery Shelf.
In this episode, Chris and Mars review the classic presentation of postoperative urinary retention, major risk factors including spinal anesthesia, opioids, anticholinergic medications, benign prostatic hyperplasia, and prolonged surgery, and why bedside bladder scanning is the essential first test.
You’ll learn specific bladder-volume thresholds that can trigger catheterization, when to use intermittent versus indwelling catheterization, the role of alpha-blockers such as tamsulosin, and how to distinguish urinary retention from postoperative oliguria and acute kidney injury.
We also cover a critical exam trap: urinary retention with new leg weakness or saddle anesthesia after spine surgery should raise immediate concern for an acute neurologic emergency.
Surgery Shelf Prep is sponsored by Scrub Battle. Download Scrub Battle: CK from the iOS App Store for five new high-yield clinical questions every day.
Use the offer code Surgery1 for your first month free as an introductory offer.
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