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Urinary Disorders

Post obstructive diuresis

12/13/2006

Question:

my 16 yr. old daughter suffered a rupture appendix. she came out of surgery with no catheter. He abdomen was swollen as if she was pregnant and in intence pain. Day 6 after surgery they finally did a C T of her tummy and put in a catheter.She urinated 300cc before catheter another 800cc pretty much immediately and within 8 hours released another 2700cc. Now she has post obstructive diuresis..What I want to know is why this has happened..what has caused this from the start..should she have had a catheter after surgery? Should a C T have been done sooner....(due to the pain and swelling alone)...did everyone fail to notice she was not releasing fluids as quick as she was taking them in...What are the long term problems associated from this condition.....As of today she has to self catheter herself every for hours for the next 2 weeks.....Help me to understand....Explain to me what to expect now...

Answer:

This question has been forwarded by Anesthesia:

Post obstructive diuresis is the passage of large volumes of urine after a urinary obstruction has been relieved. The need to perform intermittent catheterization is usually required when the bladder does not work and in order to empty it a catheter must be used.

It seems to me that this is two problems not one. Post obstructive diuresis is usually temporary and usually resolves completely. The need to perform intermittent catheterization is usually due to a longstanding problem and is often not easily resolvable--it is often a chronic condition, not due to a temporary inciting cause such as a post operative abdominal swelling.

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Response by:

R Bruce  Bracken, MD R Bruce Bracken, MD
Professor of Surgery
College of Medicine
University of Cincinnati