Synopsis
Recognise silent chronic retention, identify upper tract and renal risk, and choose a safe drainage, investigation and follow-up strategy.
- Chronic retention can be painless and compatible with continued voiding, overflow leakage or new nocturnal enuresis.
- Residual volume describes incomplete emptying; it does not directly measure bladder storage pressure or compliance.
- Hydronephrosis and renal dysfunction identify threatened organs and require prompt decompression and specialist assessment.
Investigation priorities
Establish whether chronic retention is associated with kidney injury or dangerous biochemical disturbance.
Management branches
Chronic retention is accompanied by hydronephrosis or renal dysfunction attributable to obstruction.
- Arrange prompt drainage and urology involvement, checking urethral safety and baseline observations. Treat dangerous electrolyte abnormalities and infection in parallel; a symptom medicine should not delay decompression.
- Allow continuous drainage and record the initial retained volume separately from later output. Monitor blood pressure, fluid balance and urine production, with inpatient observation when biochemical or clinical risk warrants it.
A patient has chronic residual urine without current renal or infectious complications.