Reduction in glomerular filtration rate (GFR) leading to ischemia and damage to juxtamedullary nephrons.Down-regulation of the sodium transport mechanism in the thick, ascending loop of Henle.Progressive reduction in medullary concentrating ability due to vascular washout.The exact etiology is unclear, but it certainly involves several mechanisms such as the following: Risk factors associated with post-obstructive diuresis include the presence of other lower urinary tract symptoms, diabetes, history of multiple urethral catheterizations, prostatic hyperplasia, fecal impaction, and the use of anticholinergic medications. If the post-obstructive diuresis condition becomes pathologic, it can cause serious consequences such as dehydration, electrolyte abnormalities, hypotension, hypovolemic shock, and even result in death. Post obstructive diuresis is not typically an issue unless the residual urine is 1,500 cc or more. Normal maximum bladder capacity is about 450 cc to 500 cc. Post-obstructive diuresis is an abnormal condition of prolonged polyuria, involving both excessive salt and water loss, after the acute drainage and decompression of a distended bladder, typically from urinary retention. Retention can be confirmed with a post-void residual determination either with a bladder ultrasound or a catheterization. It should be suspected in any patient with lower abdominal discomfort and any degree of urinary difficulty. Urinary retention is a relatively common urological problem encountered in both inpatient and outpatient situations. Review the coordination among the interprofessional team to enhance care for patients affected by post-obstructive diuresis.Outline how to manage post-obstructive diuresis.Summarize the dangers of post-obstructive diuresis.Explain when post-obstructive diuresis should be considered.This activity reviews the evaluation and management of post-obstructive diuresis and highlights the role of interprofessional team members in collaborating to provide well-coordinated care and enhance outcomes for affected patients. Post-obstructive diuresis can cause serious consequences such as dehydration, electrolyte abnormalities, hypotension, hypovolemic shock, and even result in death. Post-obstructive diuresis is not typically a concern unless the post-void residual volume is greater than or equal to 1,500 cubic centimeters. Normal maximum bladder capacity is about 450 to 500 cubic centimeters. Post-obstructive diuresis can occur after the acute drainage and decompression of a distended bladder and results in prolonged polyuria with excessive loss of both salt and water. Retention can be confirmed with a post-void residual volume determination either with a bladder ultrasound or via catheterization. It should be high on the differential diagnosis of any patient with lower abdominal discomfort and urinary symptoms. Urinary retention is a relatively common urological problem encountered in both inpatient and outpatient settings.
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