Urinary Retention in the Elderly: A Study of 100 Hospitalized Patients

Abstract

To estimate the prevalence of incomplete bladder emptying by the elderly and to determine its significance and its relationship to overflow incontinence. Survey comparing groups with and without incomplete bladder emptying. A geriatric hospital ward. One hundred patients who were consecutively admitted, with an average age of 82.6 years. A physical examination, perineal examination, micturition assessment, and evaluation of the post-voiding residual urine volume (PRUV) by ultrasonography at day 1 and day 8 following admission. One-channel cystometry and urine cultures were also done. Between-group comparison was performed between groups R (ie, PRUV greater than 50 mL) and C (ie, PRUV less than 50 mL). The prevalence of PRUV greater than 50 mL was 34%. Group R patients presented with greater dependency; death was the final outcome of hospitalization in 36% of these cases (vs only 9% in group C). A high PRUV was not correlated with urinary tract infection or renal failure, but there was a strong, almost significant trend toward incontinence being more prevalent in R (57%) than in C (38%) (P = 0.06). Group R presented a hypotonic bladder in 45% of cases, evidenced by cystometry, versus 6% in group C. In cases with a high PRUV, the utmost caution is necessary both in the diagnosis of overflow incontinence and in establishing a therapeutic approach. Incomplete bladder emptying is associated with a poor prognosis.