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अमूर्त

Buprenorphine–Induced Urinary Hesitancy is Common and Managed with Ease: A Retrospective Chart Review

Anjali Varma, Jessica B Long, Joseph Iskandar, Mamta Sapra

Buprenorphine is a partial agonist at the mu opioid receptor. As compared to methadone, it has the advantage of being used in office based treatment setting, making this a preferred treatment option for opioid dependence. While opioid-induced urinary retention and hesitancy are well known, urinary hesitancy in patients who receive buprenorphine treatment may go unrecognized and untreated. Objectives: The current study is a retrospective chart review of 104 charts of patients with a diagnosis of opioid dependence who received buprenorphine/naloxone treatment to examine the incidence of urinary hesitancy and identify the relationship of symptoms, if any, with the dose and duration of treatment and other patient and treatment factors. Results: Forty-five percent of patients reported no side effects, while 26% of the subjects reported urinary hesitancy symptoms at some point in treatment. Urinary symptoms were reported as early as one day and predominantly in the first 2 weeks after initiation of bup/nlx treatment. Conclusion: Urinary hesitancy occurs with buprenorphine is often under reported and may go untreated. It may lead to significant discomfort and could possibly interfere with patient compliance to buprenorphine treatment. In most cases the symptoms are mild and transient and can easily be treated with increased fluid intake and use of bethanechol, a cholinergic drug that has long been used for non-obstructive urinary hesitancy or retention, at low doses. Education of providers and patients regarding this early and tr