PROFILE AND MANAGEMENT OF CHILDREN WITH URINE RETENTION AT A TERTIARY HOSPITAL IN A DEVELOPING COUNTRY

Abstract

Background: Urine retention is an important urologic emergency among children that is widely studied in the developed world but sparse literature exists in developing countries. Purpose: To describe the profile of children with urine retention and the options of management at the Komfo Anokye Teaching Hospital, a tertiary hospital in Kumasi, Ghana. Methods: We retrospectively recorded data of children who presented with urine retention at the Komfo Anokye Teaching Hospital, Kumasi, from 1stFebruary2012 to 30thDecember, 2012.The subjects’ demographic data, clinical presentation, diagnosis, investigations and type of treatment offered were obtained. The data was analyzed using SPSS 20.0 for Windows. Results: All the thirteen children who presented with urine retention during the study period were males. The mean age was 2.9 years. The causes of urine retention were; posterior urethral valves 9(69.2%), valve bladder syndrome 2(15.4%) and one each of bladder calculus and phimosis. For each of the two patients with valve bladder syndrome following valve ablation for posterior urethral valves, renal ultrasound scan showed bilateral hydronephrosis, with elevated serum creatinine and high post void residual urine. Combined day time clean intermittent catheterization and overnight bladder drainage was instituted for them. The definitive treatment of the posterior urethral valves was endoscopic valve ablation in 7(53.8%) and catheter valve ablation in 2(15.4%). Open cystolithotomy and circumcision were offered to the subjects with bladder calculus and phimosis respectively. Immediate relief of urine retention was varied requiring the use of urethral catheterization 3(33.3%), suprapubic cystostomy 2(22.2%), or vesicostomy 2 (22.2%). Conclusion: At the Komfo Anokye Teaching Hospital, urine retention among children was largely due to posterior urethral valves. Investigations to establish diagnosis of underlying cause of urine retention was attainable. Definitive treatment was varied and tailored to the underlying cause after initial relief of retention.