Acute urinary retention in children: a systematic review and meta-analysis.

Abstract

Purpose: Acute urinary retention (AUR) in children is a rare but significant urological emergency, characterized by an inability to void despite a full bladder. Despite its clinical significance, standardized diagnostic and management protocols are lacking, and the long-term outcomes remain poorly understood. This systematic review and meta-analysis aim to synthesize data on the prevalence, risk factors, etiologies, and treatment outcomes of AUR in pediatric patients.

Methods: Following PRISMA guidelines, a systematic literature search was conducted across PubMed, Scopus, and CINAHL Ultimate databases until January 2025. Eligible studies included pediatric AUR cases (< 18 years) with at least ten patients. Meta-analysis was performed using a random-effects model. Sensitivity analyses and funnel plots were employed to evaluate robustness and potential publication bias.

Results: Eight studies (n = 611 patients) were included. The pooled prevalence of infectious causes was 26.9% (95% CI: 16.0%-39.4%), obstructive causes 19.0% (95% CI: 7.4%-34.1%), and neurological causes 6.4% (95% CI: 2.6%-11.6%). Other identified causes included post-procedural (6.9%, 95% CI: 0.8%-17.2%), bladder musculature dysfunction (3.8%, 95% CI: 0.8%-8.2%), external compression (11.1%, 95% CI: 7.6%-15.1%), and idiopathic (14.6%, 95% CI: 9.9%-20.0%). Catheterization was the primary treatment, with most requiring intervention and some resolving spontaneously. Recurrence was also observed in a few cases.

Conclusion: Pediatric AUR presents a complex diagnostic challenge due to diverse etiologies and varying clinical presentations. Early recognition and targeted intervention are critical in reducing complications. Future studies should focus on standardizing diagnostic protocols and long-term follow-up to optimize management strategies for pediatric AUR.