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Case presentation of urinary retention one day after phacoemulsification in a patient who received pre-op atropine as a measure against IFIS

Poster Details

First Author: E.Chatzispasou GREECE

Co Author(s):                  

Abstract Details



Purpose:

The purpose of this article is to present the case of a patient, who developed urinary retention following atropine treatment and uneventful phacoemulsification surgery.

Setting:

The Red Cross Hospital, Athens, Greece.

Methods:

A 78 year old patient, with a personal history of benign prostate enlargement regularly treated with tamsulosin, was submitted to phacoemulsification cataract surgery. He received atropine b.d. for two days before surgery and two drops of atropine on the day of the operation. He did not interrupt at any point his tamsulosin treatment. During the operation, which was otherwise uneventful, iris retractors had to be used, because of poor iris dilation.

Results:

A few hours after surgery, the patient sought medical assistance for acute abdominal pain and was diagnosed with urinary retention, which was subsequently treated with the placement of a bladder catheter.

Conclusions:

Tamsulosin is considered to be a major predisposing factor to IFIS (Intraoperative Floppy Iris Syndrome), which is a significant nuisance for cataract surgeons. Among the various measures that have been proposed to prevent its occurrence, is pretreatment with atropine. The latter is an anticholinergic drug that acts as a competitive antagonist for the muscarinic acetylcholine receptors. It has been used as treatment for bladder hypermobility and enuresis. At least as far as this patient was concerned, atropine pretreatment not only did not alleviate the symptoms of IFIS, but it may also have contributed to the occurrence of urinary retention, which is a troublesome urological emergency. FINANCIAL INTEREST: NONE

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