Paediatric Acute Urinary Retention in Central Queensland

Abstract

Background

The aetiology of paediatric acute urinary retention (PAUR) is poorly documented across English medical literature and none from Australasia. This study aimed to document incidence, aetiology and associated time to diagnoses and treatment of PAUR in regional Australia.

Methods

This was a retrospective study of children aged 0–17 years at presentation to two regional hospitals from 01.01.2008–31.12.2018. Data were extracted from patient files following a search for documented cases of acute urinary retention.

Results

There were 56 presentations from 53 children with sex ratio (M:F) of 1.4:1. The median age at presentation was 5.9 (IQR 2.8, 13.3) years, with bimodal peaks at 2–4 years and 12–16 years. Using Poisson regression model, the population incidence increased over the period (p < 0.05). The commonest aetiologies were post-operative (13; 23%), medications excluding anaesthesia (7; 13%), urinary tract infection (UTI) (6; 11%) and phimosis/balanitis (6; 11%), faecal impaction (6; 11%), neoplasia (5; 9%) and uncertain (10; 18%). Time to diagnosis had a median of 3 (IQR 0,14.5) h and a mean of 9.2 (±13.7) h. Time to treatment had a median of 0 (IQR 0,2.5) h and a mean of 3.6 (±11.2) h. Most cases (43/47; 92%) had successful urethral catheterisation, with one requiring suprapubic tap. Nine cases (16%) spontaneously resolved. Analgesia was provided in 49 cases (88%). Majority (40; 71%) were discharged and 15(27%) cases referred.

Conclusion

The most common aetiologies for PAUR were post-operative causes, medication use, UTI, phimosis/balanitis and faecal impaction, all providing opportunities for intervention. The incidence significantly increased over time. Diagnoses and treatment were early in most cases.