Loperamide cause of prolonged urinary retention after acute gastroenteritis

Area of Science:

• Pediatric Urology
• Clinical Pharmacology

Background:

• Urinary retention is a rare condition in pediatric patients.
• Loperamide is commonly used for acute gastroenteritis in children.

Observation:

• A 10-year-old girl experienced prolonged urinary retention after oral loperamide treatment for gastroenteritis.
• Initial diagnostic evaluations, including MRI, cystography, and renal ultrasound, revealed no abnormalities.
• The patient required catheterization for bladder emptying and subsequently underwent a year of clean intermittent catheterization.

Findings:

• This case represents a rare instance of prolonged urinary retention potentially linked to loperamide use in a child.
• Percutaneous posterior tibial nerve stimulation (SANS) was unsuccessful in resolving the retention.
• Recovery was achieved through clean intermittent catheterization over one year.

Implications:

• Pediatricians must be aware of the potential for rare, chronic adverse effects associated with over-the-counter medications like loperamide.
• Loperamide-induced urinary retention should be considered in the differential diagnosis for prolonged urinary retention in pediatric patients.
• This underscores the importance of careful medication review and monitoring, even for commonly used drugs.