Urinary Retention as a Cause of Hyponatremia in an Elderly Man

Abstract

Hyponatremia is a common disorder in elderly and can result in changes in cognition, seizures, coma or even respiratory arrest if not recognised and treated. Syndrome of inappropriate anti diuretic hormone secretion (SIADH) is the most common cause of hyponatremia in elderly hospitalised patients and in most cases the etiology cannot be determined on routine investigations. We present a 76 year old male with symptomatic hyponatremia who had chronic urinary retention due to a urethral stricture. His sodium levels improved with catheterisation and worsened again after the catheter was removed. This supports the hypothesis that urinary retention and bladder distension can stimulate ADH release from the posterior pituitary, producing a picture similar to SIADH.

Urinary retention and syndrome of inappropriate antidiuretic hormone secretion (SIADH) secondary to impacted gravid uterus

“…described five elderly hospitalized patients who developed urinary retention followed by hyponatremia and confirmed SIADH. Likewise, Mahajan et al . reported a 76‐year‐old man who was diagnosed with SIADH resulting from urinary retention.…”

“…reported a 76‐year‐old man who was diagnosed with SIADH resulting from urinary retention. Interestingly, similarly to our case, this patient's sodium level normalized after catheterizing the bladder . These reports have suggested that the bladder distention associated with urinary retention can stimulate antidiuretic hormone (ADH) release from the posterior pituitary .…”

“…Galperin et al 7 described five elderly hospitalized patients who developed urinary retention followed by hyponatremia and confirmed SIADH. Likewise, Mahajan et al 8 reported a 76-year-old man who was diagnosed with SIADH resulting from urinary retention. Interestingly, similarly to our case, this patient's sodium level normalized after catheterizing the bladder.…”

“…Interestingly, similarly to our case, this patient's sodium level normalized after catheterizing the bladder. 8 These reports have suggested that the bladder distention associated with urinary retention can stimulate antidiuretic hormone (ADH) release from the posterior pituitary. 7,8 It is also postulated that the hypersecretion of ADH may be mediated by the activation of the limbic system caused by the pain associated with bladder distention.…”

No toda la culpa fue de la COVID

“…Existen pocos casos descritos en la literatura 3 , 4 , 5 , 6 , 7 . Se cree que la distensión vesical produce una liberación de vasopresina a nivel hipofisario 8 .…”