Other Causes of Failure of Lower Urinary Tract Drainage

Most other causes of failure of lower tract drainage in women are mentioned above (Sect. 11.3.2) as causes of BOO progressing to AUR. In addition, traumatic urethral disruption can occur in female patients, although less commonly than in males. The management is the same, with diagnosis being the key as well as managing a potentially multiply injured patient (American College of Surgeons 1997).

Luminal lesions such as urethral caruncles, which can be seen protruding from the external urethral meatus as a fleshy mass, can thrombose and cause obstruction, and these can usually be managed by transurethral resection prior to catheterization. Urethral diver-ticula, if they become infected, can lead to AUR, but this is an uncommon mode of presentation.

Other lesions of the urethra and bladder base, as mentioned above, can usually be diagnosed from history and examination in correlation with urethrocystos-copy, and if they are causing obstruction or AUR, can then be managed appropriately.

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