Acute and chronic urine retention among adults at the urology section of the Accident and Emergency Unit of Komfo Anokye Teaching Hospital, Kumasi, Ghana

Abstract

Introduction: The causes and management of acute urine retention (AUR) and chronic urine retention (CUR) are different and varied in both gender and age. Urine retention has been well studied among males worldwide, while data on urine retention among women are sparse. This study aimed at determining the causes and management of AUR and CUR among adults at the Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana.
Subjects and methods: A prospective study was conducted during 8 months period. The study was carried out at the Urology and Accident and Emergency Units of KATH. A complete work-up to establish the cause of urine retention preceded data collection. The subject’s demographic data, causes and management of urine retention with outcomes were recorded on data sheet. Data was analyzed using Stata version 12.0.
Results: Two hundred and six subjects were enrolled in the study. There were 198 men and 8 women with mean ages of 62.8 ± 16.8 and 55.4 ± 18.4 years  respectively. The prevalence of AUR and CUR in the population were 172 (83.5%) and 34 (16.5%) respectively. Among the males 169 (85.4%) presented with AUR while 29 (14.6%) presented with CUR. The causes of AUR or CUR in men were: benign prostatic enlargement (BPE) 115 (58.1%), urethral stricture 29 (14.7%), carcinoma of the prostate 26 (13.1%), traumatic urethral injury 26 (13.1%) and others 1%. AUR was found in 3 (37.5%) and CUR in 5 (62.5%) of the women  studied. Two women each had bladder carcinoma and neurogenic bladder respectively. One each of utero-vaginal prolapse, bladder stones, urethral tumour and urethral trauma respectively were also found. Urinary tract infection occurred in 20 (9.7%) and renal insufficiency in 32 (16.5.0%) of respondents. The mean  volume of urine drained on catheterization was 800.0 ± 161.7 ml. The immediate treatment was by urethral catheterization in 146 (70.9%) and suprapubic  cystostomy in 60 (29.1%). The definitive treatment for the underlying causes of urine retention was varied.
Conclusions: Acute and chronic urine retention is not uncommon, but credible baseline data on this condition is nonexistent at KATH, Kumasi. Urine retention found among the participants was mainly AUR. Men were the most affected with benign prostatic enlargement, being the leading cause. Among women, acute or chronic urine retention was caused mainly by bladder cancer and neurogenic bladder. Initial and definitive management were varied between causes, gender and age.