Outcome and follow-up
After completion of the urogynecology workup which failed to demonstrate
any evidence of other etiology to account for retention complaints,
recommendations were made to turn off the pain pump. Ultimately, the IPP
was disabled and a voiding trial was performed 48 hours later. The
patient was then able to void spontaneously with PVRs less than 150 cc.
During this time, the patient took one tablet of acetaminophen 300
mg-codeine 30 mg orally every 6 hours. Morphine sulfate was identified
as the cause of urinary retention. She was transitioned to intrathecal
fentanyl for pain management. She repeatedly demonstrated both objective
and subjective evidence of adequate voiding with post-void residuals of
approximately 150cc.