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Background: Guidelines for urinary catheterization in patients with hip fracture recommend limiting catheter use and using intermittent catheterization preferentially to avoid complications such as urinary tract infection (UTI) and postoperative urinary retention (POUR). We aimed to compare current practices to clinical guidelines, describe the incidence of POUR and UTI, and determine factors that increase the risk of these complications. Methods: We retrospectively reviewed the charts of patients with hip fracture who presented to a single large tertiary care centre in southeastern Ontario between November 2015 and October 2017. Data collected included comorbidities, catheter use and length of stay. We compared catheter use to guidelines, and investigated the incidence of and risk factors for POUR and UTI. Results: We reviewed the charts of 583 patients, of whom 450 (77.2%) were treated with a catheter, primarily indwelling (416 [92.4%]). Postoperative urinary retention developed in 98 patients (16.8%); however, it did not affect length of stay (p = 0.2). Patients with indwelling catheters for more than 24 hours after surgery had a higher incidence of POUR than those who had their catheter removed before 24 hours (65/330 [19.7%] v. 10/98 [10.2%]) (odds ratio [OR] 2.2, 95% confidence interval [CI] 1.06-4.38). A UTI developed postoperatively in 62 patients (10.6%). Catheter use was associated with a 6.6-fold increased risk of UTI (OR 6.6, 95% CI 2.03-21.4). Patients with indwelling catheters did not have a significantly higher incidence of UTI than those with intermittent catheterization (57/416 [13.7%] v. 2/34 [5.9%]) (p = 0.2). Patients who developed a UTI had significantly longer catheter use than patients who did not (p < 0.002). Conclusion: Indwelling catheters were used frequently, which suggests low compliance with clinical guidelines. Longer duration of catheter use led to higher rates of UTI and POUR. Further investigation of the reasons for the common use of indwelling rather than intermittent catheterization is needed. Contexte : Les lignes directrices pour le cathétérisme vésical chez les patients ayant subi une fracture de la hanche préconisent de limiter la pose de sondes à demeure et d'opter plutôt pour le cathétérisme intermittent afin d'éviter les complications telles que l'infection urinaire (ou cystite) et la rétention urinaire postopératoire (RUPO). Nous avons voulu comparer les pratiques actuelles et les lignes directrices cliniques, établir l'incidence des cas de RUPO et d'infection urinaire et déterminer quels facteurs exacerbent le risque à l'égard de ces complications. Méthodes : Nous avons procédé à une analyse rétrospective des dossiers de patients victimes d'une fracture de la hanche ayant consulté dans un grand centre hospitalier universitaire du Sud-Est de l'Ontario entre novembre 2015 et octobre 2017. Les données recueillies incluaient les comorbidités, l'utilisation de cathéters et la durée du séjour. Nous avons comparé le recours au cathéter par rapport aux lignes directrices et évalué l'incidence des cas de RUPO et d'infection urinaire, et les facteurs de risque. Résultats : Nous avons analysé les dossiers de 583 patients, dont 450 (77,2%) se sont fait poser un cathéter, principalement à demeure (416 [92,4%]). La rétention urinaire postopératoire a affecté 98 patients (16,8%); par contre, cela n'a pas influé sur la durée du séjour (p = 0,2). Les patients qui ont gardé leur sonde à demeure pendant plus de 24 heures après leur chirurgie ont présenté une incidence plus élevée de RUPO que ceux dont la sonde a été retirée en moins de 24 heures (65/330 [19,7%] c. 10/98 [10,2%]) (rapport des cotes [RC] 2,2, intervalle de confiance [IC] de 95% 1.06-4.38). L'infection urinaire postopératoire a affecté 62 patients (10,6%). Le recours au cathéter a été associé à une augmentation par un facteur de 6,6 du risque d'infection urinaire (RC 6,6, IC de 95% 2.03-21.4). Les patients à qui on avait posé une sonde à demeure n'ont pas présenté une incidence significativement plus élevée d'infection urinaire comparativement aux patients soumis à un cathétérisme intermittent (57/416 [13,7%] c. 2/34 [5,9%]) (p = 0,2). Les patients qui ont présenté une infection urinaire ont gardé leur sonde significativement plus longtemps que les autres patients (p < 0,002). Conclusion : Les sondes à demeure ont été utilisées souvent, ce qui n'est pas conforme aux lignes directrices cliniques. Une sonde portée plus longtemps a entraîné une hausse des taux d'infection urinaire et de RUPO. Il faudra explorer les raisons de l'utilisation répandue des cathéters à demeure plutôt qu'intermittents., Hip fractures are a major cause of disability, morbidity and mortality. (1-3) Most patients present with multiple comorbidities, which contributes to an increased risk of postoperative complications. (4) Two common [...]

Author(s): Hannah Jeffery [sup.1] , Swati Jha [sup.2] Author Affiliations: (1) Department of Paediatric Surgery, Sheffield Children's Hospitals, , Sheffield, UK (2) grid.31410.37, 0000 0000 9422 8284, Department of Urogynaecology, [...]

Author(s): Hannah Jeffery [sup.1] , Swati Jha [sup.2] Author Affiliations: (1) Department of Paediatric Surgery, Sheffield Children's Hospitals, , Sheffield, UK (2) grid.31410.37, 0000 0000 9422 8284, Department of Urogynaecology, [...]

Abstract Two audits in the same hospital, one retrospective and the other prospective, are compared in this article to establish the frequency of urinary retention among children with orthopaedic conditions [...]

Steggall MJ (2007) Acute urinary retention: causes, clinical features and patient care. Nursing Standard. 21, 29, 42-46. Date of acceptance: January 16 2007. Summary This article provides an overview of [...]

Acute urinary retention is frequently cited as a potential complication of surgical procedures. The possible causes of this problem include the procedure itself, a drug-related event (for example, following the [...]

Byline: Anita T. Layton (1), Harold E. Layton (2) Abstract: aThe urine concentrating mechanism of mammals and birds depends on a counterflow configuration of thousands of nearly parallel tubules in the medulla of the kidney. Along the course of a renal tubule, cell type may change abruptly, resulting in abrupt changes in the physical characteristics and transmural transport properties of the tubule. A mathematical model that faithfully represents these abrupt changes will have jump discontinuities in model parameters. Without proper treatment, such discontinuities may cause unrealistic transmural fluxes and introduce suboptimal spatial convergence in the numerical solution to the model equations. In this study, we show how to treat discontinuous parameters in the context of a previously developed numerical method that is based on the semi-Lagrangian semi-implicit method and Newton's method. The numerical solutions have physically plausible fluxes at the discontinuities and the solutions converge at second order, as is appropriate for the method. Author Affiliation: (1) Department of Mathematics, University of North Carolina, Chapel Hill, North Carolina 27599, USA. e-mail: layton@amath.unc.edu, US (2) Department of Mathematics, Duke University, Durham, North Carolina 27708, USA. e-mail: layton@math.duke.edu, US Article note: Received: 13 November 2001 / Revised version: 28 June 2002 / Published online: 26 September 2002 This work was supported in part by the National Institutes of Health (National Institute of Diabetes and Digestive and Kidney Diseases, grant DK-42091.) Mathematics Subject Classification (2000):a65-04, 65M12, 65M25, 92-04, 92C35, 35-04, 35L45 Keywords or phrases:aMathematical models -- Differential equations -- Mathematical biology -- Kidney -- Renal medulla -- Semi-Lagrangian semi-implicit

Finasteride therapy may reduce the need for prostate surgery and the risk of acute urinary retention in men with enlarged prostate glands. Researchers treated 3,040 men for four years with finasteride or placebo, and monitored urinary symptoms, complications, and the need for surgical treatment. During the study, 10% of men taking the placebo required prostate surgery, compared to 5% of men taking finasteride. An inability to urinate developed in 7% of men taking the placebo and 3% of men taking the drug. Finasteride therapy caused the prostate to shrink and increased the flow of urine.

Phodiesterases (PDEs) play an important role in the regulation of atrial natriuretic peptide (ANP) activity of aldosterone synthesis. However, information about the specific action of PDEs to ANP regulation remain lacking. In a study of ANP resistance in rats with experimental nephrotic syndrome, intravenous injection of normal saline caused the doubling of ANP immediately after injection. In contrast, hydropenic controls and normal rats showed a rapid increase in sodium excretion. These results suggest that increased enzyme activity reduces the role of ANP in sodium retention.

The properties of efferent renal sympathetic nerve activity (ERSNA) in chronic renal sodium handling in the rat were characterized using three methods: mean integrated voltage over time, power spectrum analysis, and sympathetic peak detection analysis. These disease models assumed that ERSNA increases sodium excretion and water retention.

Introduction Proximal femoral fracture is regarded as a complication of osteoporosis. The incidence of hip fracture rises exponentially with age and risk of fracture is related to measures of bone [...]

Organic osmolytes removed from the renal medullary cells by chronic diuresis can be reaccumulated by the stimulation of a renal concentrating mechanism by 1-desamino-8-D-arginine vasopressin (DDAVP). DDAVP initially increases the intracellular ionic strength and then stabilizes the intracellular electrolyte concentration followed by aggregation of organic osmolytes. The retention of organic osmolytes in the medulla may be restricted by decreased transport and synthetic ability.

Examinations of the lower colon and cloaca of the Ostrich illustrated their dependence on kidney functioning in regulating their voided fluid composition. Proctodeum and coprodeum, which are parts of their cloaca, perform the respective tasks of storing excess urine by acting as a bladder and retaining uric acid.