부동화에 의해 유발된 요정체와 변비를 동반한 고령의 여성 환자 증례

Urinary Retention and Constipation Associated with Immobility in an Elderly Woman: A Case Report

Immobilization causes various complications in the urinary, gastrointestinal, respiratory, cardiovascular, and musculoskeletal systems in elderly patients. An 83-year-old female with immobility after a lumbar compression fracture that occurred a month ago presented the emergency room with dysuria, fever, and abdominal pain from the previous day. Colon fecal impaction, mild right hydronephrosis, and bladder distension were shown in the computed tomography of the abdomen and pelvis. Symptoms improved after insertion of urethral catheter, finger enema, and glycerin enema. After hospitalization, urethral catheter removal was attempted, but there was persistent urinary retention. As a result of consultation with the urology department, it was determined that the detrusor muscle was weakened due to immobilization, and surgery was performed on lumbar compression fractures in orthopedics. After the operation, the patient was transferred to the department of rehabilitation medicine for active rehabilitation treatment. She was discharged with a walker and wheelchair ambulation after relieving her constipation symptom and smoothly urinating herself during rehabilitation. There are many causes of urinary retention in elderly patients; the possibility of urinary retention due to immobility must always be considered, and a multifactorial therapeutic approach is needed. If the disease that caused immobility is treatable, active treatment should be considered to prevent complications from immobilization.