POUR

Q: Urinary bladder distension in ICU may cause? (select one)

A) Tachycardia
B) Bradycardia
C) Both (either)


Answer:   C 

With pain of bladder distension tachycardia is expected but any visceral distention like that of bowels or urinary bladder may cause a symptomatic bradycardia due to vagal reflex. 

Typically known as POUR (postoperative urinary retention), is usually a transient phenomenon but may stay for a significant period of time to cause hemodynamic instability. age, gender (male), drugs, type of anesthesia, underlying neurologic diseases are well-known risk factors. Beside urologic or bowel surgery, it may be of interest to know that joint arthroplasty is another risk factor. One time bladder catheterization (straight cath) should be performed if bladder scan determines >600 mL of urine. 

#surgicalcriticalcare
#urology



 Reference: 

Baldini G, Bagry H, Aprikian A, Carli F. Postoperative urinary retention: anesthetic and perioperative considerations. Anesthesiology 2009; 110:1139.