Urinary Tract Infection

UTI is extremely common in women, although it is rarely complicated and usually managed in primary care. It is, however, the one of the most common causes of voiding dysfunction in female patients. It frequently causes symptoms of AUR, but the patient may be able to void small volumes but associated with significant discomfort. The cause of the retention is most likely the patient preventing herself from voiding to prevent these symptoms, and the patient rarely needs catheterization, with most settling with a course of antibiotics. Very occasionally, patients have high residual volumes and a complete inability to void, in which cases catheterization is needed, but again the majority of these settle quickly with antibiotic therapy and need no further treatment.

There is an argument for investigating women with recurrent UTIs to exclude other causes of BOO, such as pelvic prolapse, urethral stricture, meatal stenosis, urethral diverticulum, Skene's gland cysts or abscesses, bladder stones, or tumor of the urethra or bladder (Goldman and Simmern 2006). Clinical examination coupled with out-patient flexible urethrocystoscopy is usually sufficient to rule out most lesions, although if urethral diverticulum is suspected MRI is the gold standard (Patel and Chapple 2006).

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