So, a trial of an alpha blocker is reasonable, but a substantial number of men with spontaenous acute retention of urine will end up going back into retention and will therefore eventually come under the care of a urologist for TURP.
RETENTION IN PATIENTS WITH A CATHETERISABLE STOMA
An increasing number of patients have undergone reconstructive surgery involving the formation of a catheterisable stoma, such as a Mitrofanoff stoma.
Patients with a Mitrofanoff catheterisable stoma are sometimes unable to pass a catheter into their stoma. This not infrequently occurs after spinal or other surgery. The spinal surgery may change the 'angle' of the stoma or their bladder may become overfull in the post-operative period which again may distort the stoma to the extent that it is difficult to pass a catheter. In this situation, attempting to pass the catheter yourself, using plenty of lubrication, is reasonable. If you fail, try to pass a floppy guidewire through the stoma (preferably under radiological control if this is available). This may pass into the bladder where the catheter will not. A catheter, with the tip cut off, can then be passed over the guidewire and into the bladder. If this fails, pass a suprapubic catheter, empty the bladder, and then usually the patient will be able to pass their catheter without any problems.
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