ANURIA

Abstract

This chapter describes the diagnosis of anuria. Anuria—or suppression of urine—must be distinguished from retention of urine, in which urine is secreted from the kidneys but is retained in the bladder from some lesion causing obstruction to the urethra, such as urethral stricture or prostatic enlargement in the male; pressure or drag upon the urethra by a large pelvic tumor or a retroverted gravid uterus in the female; or without urethral obstruction in various forms of injury or disease of the spinal nervous system affecting the lumbar centers. In acute retention of urine, apart from the neurological variety, there is pain above the pubes, often a constant and urgent desire to pass urine, and the distended bladder forms a tense, oval, dull tumor above the pubes in the middle line. Anuria may be caused by obstruction to the outflow of urine from the kidneys or to failure of secretion by them. The two causes frequently act in combination. Calculous disease is the most frequent cause of obstructive anuria. It may occur at any age but is commonest in men of about forty. Anuria may also occur after a crushing injury or severe wound of a limb, after incompatible blood transfusion, excessive vomiting, septic abortion, or in the late stages of cholera, yellow fever, and blackwater fever.