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net/inosr-scientific-research/
Turyasingura
INOSR Scientific Research 9(1):50-58, 2023.
©INOSR PUBLICATIONS
International Network Organization for Scientific Research ISSN: 2705-1706
Evaluation of the Urinary Retention in Matured Male Patients at Kampala
International University Teaching Hospital in Bushenyi District Western
Uganda
Turyasingura, Enos

Department of Clinical Medicine Kampala International University Western Campus Uganda.

ABSTRACT
A comprehensive assessment of urinary retention in adult male patients who attended
Kampala International University Teaching Hospital (KIU-TH) was conducted. To determine
the number of adult male patients diagnosed with Urinary Retention (UR) to determine the
risk factors of urinary retention among adult males who were diagnosed with urinary
retention, to establish the management of urinary retention among adult males diagnosed
with urinary retention at KIU-TH between august 2015 to august 2017. A retrospective and a
descriptive study design was used, involving quantitative methods of data collection.
Purposeful sampling technique was employed, where all adult males who attended KIU-TH
between august 2015 and august 2017 were recruited in the study. From results out of 136
samples of adult male patients with UR, 63 (46.3%) had no UR and 73 (53.7%) had UR. Out of
the 73 (53.7%) adult male patients, 52 (71.2%) with presented with AUR then 21 (28.8 %) of
the people had CUR. Furthermore, of 73 (53.7%) of the adult male patients with UR, 19 (26.1%)
was in 2015 from August to December, and 32 (43.8%) adult male patients were in 2016
January to December, and 22 (30.1%) adult male patients in 2017 between January to August.
This was found more in elderly men between the age 60 to 89 years by 53 (72.6%) followed
by, 40 to 60 years by 14 (19.2%), then 23 to 40 years by 6 (8.2%) patients. The risk factors UR
were BPH, prostate cancer, urinary stricture, and others that included bladder tumors, and
urethral traumas where BPH was the leading cause of UR with 45 (61.6%) patients, followed
by 10 (13.7%) followed by urethral stricture and 5(6.8%) was due to other causes such as
bladder tumors urethral trauma and paraphimosis. 26 (35.6%) people had UR were managed
by urethral catheterization, 17 (23.3%) had UR managed by supra pubic catheterization, 23
(31.5%) had UR managed by surgery and 7 (9.6%) were managed by other measures like
medication circumcision. In conclusion Results portrayed that although the management
measures were available such urethral catheterization and surgery which were the most
practice at KIU-TH, there remained high prevalence of UR which was more in the elderly
adults commonest cause was BPH. All males above 60 years need to be assed and examined
to rule out the causes of urinary retention for early management. It is also necessary to
necessary that all males above forty years to be encouraged for BPH and early treatment of
urinary tract infections to prevent outlet obstruction ant formation strictures respectively.
Keywords: Urinary retention, adult males, Patients, Bladder tumor, Urethral catheterization.

INTRODUCTION
Urinary retention (UR) defined as the
inability to completely empty the bladder
despite it being full is rare condition
among young men compared to the elderly
where in their 70s, they become five times
more prone to the condition [1, 2, 3, 4]. UR
had been commonly an under diagnosed
condition with complications that resulted
in patient discomfort and possible
permanent damage to the lower urinary
tract [5, 6, 7]. UR was acute or chronic [1,
8, 9, 10]. In the acute form there was a
sudden inability to pass urine despite an
urge to pass urine which was usually
associated with suprapubic pain. Chronic
urinary retention (CUR) was an inability to
empty the bladder completely during
voiding which usually was not associated
with suprapubic pain [11, 12, 13, 14, 15,
16]. There could sometimes be an acute
urinary retention (AUR) on a background of
chronic urinary retention (acute-on-

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INOSR Scientific Research 9(1):50-58, 2023.
chronic urinary retention) and was one of
the common urologic emergencies
worldwide [1, 17, 18, 19, 20]. The causes
of UR were categorized as obstructive and
non-obstructive [3, 21]. The obstruction of
the lower urinary tract at or distal to the
bladder neck which could be intrinsic such
as prostatic enlargement, bladder stones,
and urethral stricture with the most
common obstructive cause being benign
prostatic hyperplasia (BPH)causing bladder
neck obstruction through two
mechanisms: prostate enlargement and
constriction of the prostatic urethra [3].
Furthermore, infection and inflammation
were the most common causes of
infectious AUR especially acute prostatitis
usually caused by gram-negative
microorganisms, such as Escherichia coli
and Proteus species, and resulted in
swelling of the urethra due to a urinary
tract infection (UTI) or sexually
transmitted infection [3]. Medications with
anticholinergic properties, such as
tricyclic, antidepressants, caused urinary
retention by decreasing bladder detrusor
muscle contraction, neurological [3].
Normal functioning of the bladder and
lower urinary tract depend on a complex
interaction between the brain, autonomic
nervous system, and somatic nerves
supplying the bladder and urethra so any
interruption of these nerves lead to UR [3].
However, when all the above causes of UR
were compared BPH was the leading cause
(51.8%) followed by urethral stricture
(20%), cancer of the prostate (7.3%),
urethral injury (7.3%) and bladder tumor
(6.4%). More than half of the adult male
patients (53.4%) usually presented with
AUR, 30.5% presented with CUR, and 16.1%
being diagnosed to have acute-on-chronic
urinary retention [3]. Although UR was a
burden to adult males globally, there were
measures to manage it using various ways
of management such as use of indwelling
urethral catheterization (IUC), supra- pubic
catheterization (SPC) and intermittent
urethral catheterization (IC) in low
developed countries [4]. Furthermore, in a
world survey on the management UR
among adult males aged 70 years and
above, prostate size of 50gwith severe
lower urinary tract symptoms, drained
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urine at catheterization of 1000 ml and
spontaneous AUR favored trail without
cauterization (TWOC). The same study
indicated that Catheterization above 3
days did not influence TWOC success but
was associated with increased morbidity
and prolonged hospitalization for adverse
events where in the case of TWOC failed,
BPH surgery was done [5]. Globally, the
overall prevalence of UR for both AUR and
CUR was not known [4]. Most of the reports
on prevalence of UR were from studies
conducted on AUR, in patients with benign
prostatic hyperplasia (BPH) and prostate
cancer however it had been estimated that
by 2018 that both the prevalence of UR and
would increase by 20%, with Africa and the
Asian countries experiencing the steepest
increase [4]. Previous studies had put the
prevalence of UR between 2.7% and 42% in
men who underwent prostatectomy in
North America and Britain [4], United
States with the rate of AUR at 4.5 per 1000
person-years based on 82 cases (1.34%) in
6,100 men included from health
professionals follow up study [4]. A recent
population – based study of 950 men in
west Africa found the prevalence of BPH,
was a common cause of UR among adult
males in Ghana [6] with 19.9% of men
experiencing UR than the United States of
America [7; 6]. In Africa UR has been on an
increase in the ageing males of the
population especially of sub-Saharan
Africa with a prevalence of 19.9 per 1000
men [8], Ghana with a prevalence BPH
among 50 -74years old were 35- 62%With
19.9% of men experiencing UR which was
similar to a study made in Sierra Leone
with 19.9 per 1000 men [7]. Burkina Faso
in the study at Bobo - diousso University
Teaching Hospital among adult men out of
155 patients, 104 (67.1%) had AUR aged
between 23 and 89 years, patients who
were over 60 years formed the majority at
77.8% [9]. In a study made in Nigeria the
prevalence of acute urinary retention was
39.3% of patients aged 65-74 years, 33.3%
above 75 years, 27.4% were below 65 years
[3]. In Uganda however there was no clear
report about UR in elderly man due to a
general record problem [4]. There was high
prevalence of this condition in men older
than 50 years of age of BPH [10] however
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Turyasingura
INOSR Scientific Research 9(1):50-58, 2023.
the prevalence of the disease is not known
but according to the study from Mulago
hospital Urology Unit showing that
symptomatic BPH was the leading cause of
admissions of UR with 177 cases of BPH
out of 742 (24%) of admissions on the ward
between January 2005 and June 2006 [11].
There was barely any study that had been
conducted in KIU-TH in Bushenyi district
in western Uganda.
Statement of Problem
Though no clear record in Uganda about
the prevalence of UR in elderly men due to
general record problem but the few studies
showed that there was high prevalence of
this condition in men older than 50 years
of age due to BPH [4; 10]. BPH was the
leading cause of admissions of UR not only
elsewhere in the world but also in Uganda
with 177 cases of BPH out of 742 (24%)
adult males admitted in Mulago hospital
among other causes [11]. However, there
was barely any information about the
prevalence of UR among adult male
patients who attended Kampala
International University Teaching Hospital
(KIU-TH) in Busheny-Ishaka municipality,
Bushenyi district. The current study seeks
to conduct a comprehensive assessment of
UR among the adult male patients who
attended KIU-TH where it included the
number of patients diagnosed with UR
causes and ways of management.
Aim of the study
To conduct a comprehensive assessment
of urinary retention in adult male patients
who attended KIU-TH.
Specific objectives
 To determine the number of adult
male patients diagnosed with UR
among adult males who have
attended KIU-TH between august,
2015 to august 2017.
 To determine the risk factors of
urinary retention among adult
METHODOLOGY
Study Design
A retrospective and a descriptive study
design was used, involving quantitative
methods of data collection.
Area of Study
The study was conducted at KIU-TH
located in Ishaka - Bushenyi Municipality,
Bushenyi District in the South Western
males who were diagnosed with
urinary retention at KIU-TH
Between August 2015 to August
2017.
 To establish the management of
urinary retention among adult
males diagnosed with urinary
retention at KIU-TH Between August
2015 to august 2017.
Research questions
What was the number of adult male
patients diagnosed with urinary
retention among adult males at KIU-
TH Between August 2015 to August
2017?
What were the risk factors of
urinary retention among adult
males diagnosed with urinary
retention at KIU-TH between august
2015 to august 2017?
What were the different
management measures of urinary
retention among adult males at KIU-
TH between august2015 to august
2017?
Justification of the study
This study was to raise the level of
awareness to the community about the
prevalence and the associated risk factors
and the management methods of urine
retention among the adult males and
health workers of KIU-TH. This would
update the available information
concerning UR, which could serve as
baseline for further intervention in
prevention and treatment of urinary
retention in western Uganda and
worldwide. Results obtained in this study
were important to the ministry of health
for better planning on how to reach the
community and lay necessary health
policies aimed at combat ion UR and its
associated risk factors among adult males
in Uganda.
region of Uganda as to appendix v. It’s
located approximately 65kms by road
from Mbarara town, the largest town in the
region and 360kms from Kampala the
Capital City of Uganda, KIU-TH was
alongside Kasese –Mbarara road according
to (Appendices III and IV). The main
language spoken in Bushenyi district was
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INOSR Scientific Research 9(1):50-58, 2023.
Runyankole as Banyankole people are the
main occupants of this area. KIU-TH was a
non-government health facility serving in
Bushenyi district population of 234,443
People, 114,207 males according to
National Population and Housing Census
2014. That area was purposely chosen
because of the high population density of
282 people per square kilometer.
Study Population
The study was involved cross examining
the records of adult males of age group 23-
Table 1: showing student’s population.
Sampling Procedure and rationale
Purposeful sampling technique was
employed, where all adult males who
attended KIU-TH between august 2015 and
august 2017 were recruited in the study.
Inclusion criteria
All adult males within the age group (23 to
89 years) who attended KIU-TH both
diagnosed with and without between
53
89 years which was similar to the age of a
study by [9]. In patients who attended KIU-
TH between months of august 2015 to
august 2017.
Sample Size Determination and Rationale
All adult male patients aged between
23years to 89years attended KIU-TH were
selected according to [12] (Appendix III),
for a population (N) of 210 adult male
patients on average, the sample size for
the given population (S) was 136
respondents.
august 2015 and august 2017 were
included in the study.
Exclusion Criteria
Adult males who had partial information in
the record books such as age, tribe, marital
status, sex, address, and people below 23
years and those above 89 years were not
included in the study.
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INOSR Scientific Research 9(1):50-58, 2023.
Research instruments
A data collection sheet was used to collect
data from KIU-TH hospital patients’
records.
Data collection procedure
After getting approval letter from the
school of allied health sciences, the
required data of adult males who meet the
criteria was recorded in the pre-designed
data collection sheet (Appendices I and II).
Data analysis and presentation
Data was presented in chats, figures and
table and statistically analyzed using
RESULTS
Prevalence of urinary retention among
adult male patients who attended KIU-TH
The results indicated that of 136 adult
male patients considered in the study
period from august 2015, 2016, to august
2017; showed that there was generally a
high percentage of adult male patients
diagnosed with UR being 73 (53.7%) which
was significantly higher (p < 0.05) than 63
(46.3%) who had no UR. Out of 73 (53.7%)
of the adult male patients diagnosed with
UR, 19 (26.1%), 32 (43.8%), 22 (30.1%) were
found to be in 2015, 2016 and 2017
respectively. However, the percentage of
adult males diagnosed with UR in 2016
(43.8%) was significantly higher (p < 0.05)
than the cases of UR in 2015 and 2017. In
addition, of the 73 (53.7%) adult male
computer software including MS-Excel
2010 and SPSS.
Ethical considerations
The approval letter was obtained from
School of Allied Health after the approval
of the proposal which was forwarded
toinstitutional research and ethical
committee (IREC) of KIU–TH for acceptance
and permission to access the patients’
records in KIU-TH.
patients, 52 (71.2%) were diagnosed with
AUR which was significantly high (p < 0.05)
than21 (28.8 %) of the people had CUR.
adult male patients in Whereby out of the
52 (71.2%), 19 (26.1%) who were in 2017;
15 (78.9%) patients had AUR and 4 (21.1%)
patients had CUR, and the 32 (43.8%)
patients in 2016; 23 (71.9%) had AUR and 9
(39.1%) had CUR while 22 patients who
were in 2017;14 (63.6%)had AUR and 8
(36.6%)were having CUR. This prevalence
of UR was found more in elderly men
between the age 60 to 89 years by 53
(72.6%) which significantly higher (p <
0.05) than the adult male patients in the
age of 40 to 60 years by 14 (19.2%), and23
to 40 years by 6 (8.2%) patients as seen in
the table 2 below.
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INOSR Scientific Research 9(1):50-58, 2023.
Table 2. Showing the prevalence of UR
NUMBER OF ADULT MALE NUMBER OF ADULT MALE TYPE OF URINARY
YEAR PATIENTS WITH OUT UR PATIENTS WITH UR REENTION

FREQUENCY PERCENTAGE FREQUENCY PERCENTAGE AUR CUR

2O15 24 38.1% 19 26.1% 15 4 (21.1%)

(78.9%)

2016 18 28.6% 32 43.8% 23 9 (39.1%)

(71.9%)

2017 21 33.3% 22 30.1% 14 8 (36.6%)

(63.6%)

Age 60-89 years with UR 40-60 years with UR 23-40 years with UR

Frequency Percentage Frequency Percentage frequency Percentage

53 72.6% 14 19.2% 6 8.2%

UR : Urinary rentetion.
AUR : acute urinary rentetion.
CUR : Chronic urinary rentetion.
Risk factors of Urinary retention which was significantly higher (p <0.05)
The risk factors were benign prostate followed by 13 (17.8%) due to Ca p,
hyperplasia, prostate cancer, urethral 10(13.7%) due to urethral stricture and
stricture, and others like trauma of the 5(6.8%) that was due to other causes as
urethra and age. Results portrayed that 45 seen in the figure below;
(61.6%) patients with UR was due BPH

6.80%
13.70% BPH

17.80% Ca P
61.60%

URETHRAL
STRINCTURE

OTHERS

Figure 1. A pie chart showing risk factors 0f Urinary retention among adult males that
attended KIU-TH

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INOSR Scientific Research 9(1):50-58, 2023.
Management of urinary retention among
adult male patients who attended KIU-TH
Results showed that there were various
management measures of UR which were
urethral catheterization with 26 (35.6%)
people had UR who were being managed by
it, 17 (23.3%) had UR managed by
suprapubic catheterization, 23 (31.5%) had
UR managed by surgery and 7 (9.6%) were
40.00%
35.00%
30.00%
25.00%
20.00%
15.00%
10.00%
5.00%
0.00%
urethral
catheterization
Figure 2: The graph showing management of UR.
DISCUSSION
The high prevalence of ur73 (53.7%)
whereby out of the 73 (53.7%) adult male
patients, 52 (71.2%) with presented with
AUR and 21 (28.8 %) of the people had CUR
the study results portrayed the percentage
of AUR was significantly higher (p < 0.05)
than CUR21 (28.8 %), this was in line with
the study conducted at the Urology and
Accident and Emergency Units of Komfo
Anokye Teaching Hospital, Kumasi, Ghana
[13]. The prevalence was high in the adults
of 60 years and above which was also in
line with the study at Bobo - diousso
University Teaching Hospital in Burkina
Faso adult [9] and this was thought to
happen with increase in age which
increases the growth the prostate.
Following the study results regarding risk
factors of UR, it was found out that BPH,
prostate cancer, urinary stricture, and
others that included bladder tumors, and
managed by other means like medication.
The results portrayed that the percentage
of the management of UR by urethral
catheterization with (35.6%) and surgery
(31.5%) were significantly higher (p < 0.05)
than suprapubic catheterization (23.3%)
and other measures like medication with
(9.6%) as seen in the graph below;
suprapubic surgery others
cathetrization
urethral traumas lead to UR where BPH was
the major risk factor of UR with 45 (61.6%)
patients whose percentage was
significantly high (p < 0.05) followed by
10(13.7%) followed by urethral stricture
and 5(6.8%) was due to other causes such
as bladder tumors urethral trauma and
paraphimosis. This study was in contrast
with the study by [3] which was thought to
be due to the increase in size of the
prostate with age. Study results portrayed
that UR was managed with measures which
was found that urethral catheterization
was commonly practiced to patient with
UR 26 (35.6%), followed by surgery 23
(31.5%), followed supra pubic
catheterization 17 (23.3%) and other
methods 7 (9.6%) by methods of
management, in addition the percentages
of urethral catheterization and surgery
(35.6%), (31.5%) significantly higher (p <
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INOSR Scientific Research 9(1):50-58, 2023.
0.05) than supra pubic catheterization 17 other methods and surgery was high
(23.3%) and other method 7 (9.6%) this because it was a permanent method of
study was it line with the study by [4]. This managing involved removal of the prostate
was thought that urethral catheterization that was obstructing urine flow.
was high because it was cheap to afford
CONCLUSION
Results portrayed that although the  It is also necessary to necessary
management measures were available such that all males above forty years to
urethral catheterization and surgery which be encouraged for BPH and early
were the most practice at KIU-TH, there treatment of urinary tract
remained high prevalence of UR which was infections to prevent outlet
more in the elderly adults commonest obstruction ant formation
cause was BPH. Therefore, the following strictures respectively.
recommendations should be done.  More recommendation goes to the
Recommendations government and ministry of health
 All males above 60 years need to be to make management measures
assed and examined to rule out the more accessible and affordable to
causes of urinary retention for all adult male patients with urinary
early management. retention.

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