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Published on: October 12, 2017
Urinary retention in children
Amihay Nevo1, Roy Mano1, Pinhas M Livne1
1Pediatric Urology Unit, Department of Pediatric Surgery, Schneider Children's Medical Center of Israel, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Insights
Urinary retention in children has diverse causes and a bimodal age distribution, often linked to severe underlying conditions. Prompt evaluation is crucial for effective treatment and preventing complications.
Area of Science:
- Pediatric Urology
- Emergency Medicine
- Pediatric Surgery
Background:
- Urinary retention in children is a critical condition requiring thorough investigation.
- Understanding its causes, demographics, and outcomes is essential for optimal patient management.
Purpose of the Study:
- To delineate the causes and outcomes of acute urinary retention in pediatric patients.
- To analyze the prevalence of urinary retention by gender and age groups.
Main Methods:
- Retrospective review of medical records for children (<18 years) presenting with acute urinary retention.
- Exclusion of postoperative cases, known neurological disorders, and neonates.
- Data analysis focused on demographics, etiology, treatment, and outcomes, stratified by age and gender.
Main Results:
- The study included 56 children (75% boys); median follow-up was 25 months.
- Common causes included mechanical obstruction (25%), infection/inflammation (18%), and fecal impaction (13%).
- Mechanical obstruction was exclusively seen in boys, with pelvic tumors noted in 5. Age distribution showed peaks at 3-5 and 10-13 years.
Conclusions:
- Pediatric urinary retention presents with varied causes and a bimodal age pattern.
- A significant proportion of cases involve severe underlying diseases, necessitating urgent and comprehensive evaluation.
- Early, thorough assessment in a hospital setting is vital for timely treatment and complication avoidance.
Objective:
To describe the causes and outcome of urinary retention in children and assess its prevalence by gender and age.
Methods:
The medical records of all children (aged <18 years) who presented to the emergency room with acute urinary retention from 2000 to 2012 were reviewed. Patients with postoperative urinary retention, a known neurologic disorder, and neonates were excluded. Data were collected on patient demographics and cause, treatment, and outcome of the urinary retention. Findings were evaluated and compared by age and gender.
Results:
The study group comprised 42 boys (75%) and 14 girls (25%). Median follow-up time was 25 months. Causes of urinary retention were mechanical obstruction in 14 patients (25%), infection or inflammation in 10 (18%), fecal impaction in 7 (13%), neurologic disorders in 6 (11%), gynecologic disorders in 4 (7%), and behavioral processes in 3 patients (5%); 12 patients (21%) were idiopathic. All patients with mechanical obstruction were boys, of whom 5 had a pelvic tumor. Age distribution was bimodal: 29% of the events occurred between ages 3 and 5 years, and 32%, between ages 10 and 13 years. Fifteen children underwent surgery. Three children required continuous catheterization during follow-up.
Conclusion:
Urinary retention in children is characterized by a variable etiology and bimodal age distribution. The high rate of severe underlying disease is noteworthy and should alert physicians to the importance of a prompt, comprehensive, primary evaluation of this patient population in a hospital setting to initiate appropriate treatment and avoid complications.
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