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Psychogenic urinary retention associated with head down tilt bed rest: A rare medical complication

Limper, Ulrich und Mulder, Edwin und Rittweger, Jörn und Bershad, Eric (2016) Psychogenic urinary retention associated with head down tilt bed rest: A rare medical complication. Human Research Program 2016, 2016, Galveston, TX, USA.

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INTRODUCTION We describe a case of recurrent urinary retention (UR) during 12 degree head down tilt (12° HDT) bed rest during the 2-campaign Space-COT study. CASE A 47 yr. healthy ♂ subject with no previous urological conditions developed recurrent, UR during 12° HDT. The first episode occurred 3 h after transition from upright to HDT. A bladder ultrasound scan confirmed a highly distended bladder. The subject was given further time to void but developed lower abdominal pain, and was still unable to void. A disposable straight catheterization was performed to empty the bladder, which returned > 1000 ml of urine with immediate relief of discomfort. During the next urinary collection, the subject was again not able to urinate in HDT position. Thus the decision was made to place an indwelling urinary catheter (Fig. 2). The catheter was placed uneventfully, but had to be removed the following night on request of the subject due to persistent urethral discomfort. On the following day, it was decided by the medical team to allow temporary interruption of the 12° HDT angle to facilitate urination. At 10° head up tilt (HUT) the subject easily urinated. Using this procedure, the subject had no further issues of urinary retention during the first campaign. In preparation for campaign 2, one week later, the subject was given a large 12° wedge (Fig. 1) and urinary bottles to practice micturition at home. He reported no voiding disturbances in HDT position at home. During campaign 2, the UR immediately reappeared during HDT, and resolved with body angle change to supine position. DISCUSSION UR has been reported for spaceflight [1, 2] but not for HDT bedrest. Given in our case that UR appeared only during 12° HDT during the study, but not in the same position at home suggests that situational anxiety played a role. Alternatively, it is possible that the subject had an undiagnosed urological condition that may have contributed to urinary dysfunction, along with psychological stress; however, no previous urological symptoms had ever been reported. CONCLUSION UR, particularly during 12° HDT bed rest, can compromise study success but may be excludable in advance by testing the 12° HDT urination procedure during the medical selection process of the subjects.

elib-URL des Eintrags:https://elib.dlr.de/118753/
Dokumentart:Konferenzbeitrag (Poster)
Titel:Psychogenic urinary retention associated with head down tilt bed rest: A rare medical complication
Autoren:
AutorenInstitution oder E-Mail-AdresseAutoren-ORCID-iDORCID Put Code
Limper, UlrichUlrich.Limper (at) dlr.dehttps://orcid.org/0000-0001-9927-4180NICHT SPEZIFIZIERT
Mulder, EdwinGerman Aerospace Center (DLR), Institute of Aerospace Medicine, Space Physiology, Cologne, GermanyNICHT SPEZIFIZIERTNICHT SPEZIFIZIERT
Rittweger, JörnJoern.Rittweger (at) dlr.dehttps://orcid.org/0000-0002-2223-8963NICHT SPEZIFIZIERT
Bershad, EricDepartment of Neurology, Baylor College of Medicine, Houston, TexasNICHT SPEZIFIZIERTNICHT SPEZIFIZIERT
Datum:2016
Referierte Publikation:Nein
Open Access:Ja
Gold Open Access:Nein
In SCOPUS:Nein
In ISI Web of Science:Nein
Status:veröffentlicht
Stichwörter:urinary retention; head down tilt bed rest; urological condition;
Veranstaltungstitel:Human Research Program 2016
Veranstaltungsort:Galveston, TX, USA
Veranstaltungsart:internationale Konferenz
Veranstaltungsdatum:2016
Veranstalter :NASA
HGF - Forschungsbereich:Luftfahrt, Raumfahrt und Verkehr
HGF - Programm:Raumfahrt
HGF - Programmthema:Forschung unter Weltraumbedingungen
DLR - Schwerpunkt:Raumfahrt
DLR - Forschungsgebiet:R FR - Forschung unter Weltraumbedingungen
DLR - Teilgebiet (Projekt, Vorhaben):R - Vorhaben Systemphysiologie (alt)
Standort: Köln-Porz
Institute & Einrichtungen:Institut für Luft- und Raumfahrtmedizin > Muskel- und Knochenstoffwechsel
Institut für Luft- und Raumfahrtmedizin > Kardiovaskuläre Luft- und Raumfahrtmedizin
Hinterlegt von: Polak, Agnieszka
Hinterlegt am:14 Mär 2018 10:59
Letzte Änderung:15 Okt 2024 10:20

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