peadiatric urinary retention

[feefee365]

my 3 year old suddenly cannot pass urine he is generally in good health he was admitted to hospital and had an MRI scan,x rays,ultra sound scans and a camera inserted into bladder and to date no cause has been found he was discharged home with a catheter insitu we are for review next week  but im worried  what will happen next and whats causing this problem

[Stephen Liroff, MD]

When the problem is in your child it certainly takes on great anxiety.
I assume that his/her urine was not infected as the burning from a urine infection prevents some children from urinating, but once treated things are usually fine. Beyond that there are several conditions that can cause retention . I would be concerned about things that affect the nerves that control urinating (spinal cord problems)as well as local bladder/prostate issues such as posterior urethral valves in boys. Eventually your child  may need some testing of the  bladder (urodynamic evaluation) to study  bladder function. Sounds as though a  good workup is being performed.
Good luck!
S.A. Liroff, M.D.


This information is provided for general medical educational purposes only. It
does not necessarily reflect the opinions of Henry Ford  Hospital  or the
Vattikuti Urologic Institute.  Please consult your physician for diagnostic
and treatment options pertaining to your specific medical  condition.

[feefee365]

dr liroff i asked you about my son  a 3 year old who has urinary retension. after 6 weeks of investigation  we are no further on he  now has a supra pubic catheter and suffering severe bladder spasms he has to use oxybutynin 3 times aday plus codeine,paracetamol,brufen. and when in hospital he had oramorph. the plan is to kick statr his bladder by clamping and unclamping  but how can we do this when the poor little boy is in such pain  please help me have you ever come across this condition before  or have you any suggestions. all his scopes, biopsys,mri scan.ultra sounds have been normal

[Stephen Liroff, MD]

Clamping and unclamping his suprapubic tube is termed bladder training and will not increase his bladder's ability to contract. His bladder spasms are evidence that he has good bladder pressure. The oxybutinin is there to relax his bladder. Intermittent catheterization is a way around the tube but will require more effort on your part.
You might consider a second opinion from another pediatric urologist. The quickest way to find one is to contact the Society for Pediatric Urology (www.spuonline.org) and request a list of members in your area or contact a university teaching hospital. Bring all the reports AND THE STUDIES THEMSELVES to the consultation.
Hope that this helps.
S.A.Liroff, M.D.
This information is provided for general medical educational purposes only. It
does not necessarily reflect the opinions of Henry Ford  Hospital  or the
Vattikuti Urologic Institute.  Please consult your physician for diagnostic
and treatment options pertaining to your specific medical  condition.