Prevalence and Clinical Implications of Post-obstruction Hyperdiuresis Among Patients with Urinary Retention: A Mini Review

Abstract

Urinary retention is a common urological emergency requiring catheterization. However, follow-up management remains poorly defined, particularly regarding post-obstruction hyperdiuresis (POHD), which may lead to complications such as hypovolemia and electrolyte disturbances. Our mini review of PODS identified nine relevant studies involving 665 patients. POHD occurred in 15–78% of cases, with a mean duration of 2–5 d. Risk factors included serum creatinine >105 μmol/l (odds ratio [OR] 4.83, 95% confidence interval [CI] 1.14–20.44; p = 0.032) and greater bladder volume (OR per 100-ml increment: 1.21, 95% CI 1.06–1.40; p = 0.006). Complications included hematuria (11–55%), hyponatremia (22–28%), and hypotension (9%), most of which were self-limiting. Data on management were sparse; one randomized controlled trial showed no significant difference in complications between rapid and gradual decompression. The lack of standardized protocols underscores the need for further prospective studies to optimize patient outcomes.

Patient summary

After relief of urinary obstruction, an increase in urination is common. Complications such as blood in the urine, electrolyte imbalances, and dehydration may occur but typically resolve on their own without additional treatment.