Your bladder is a like a small storage tank for your urine, the waste filtered from your blood by your kidneys. Normally, you void when the bladder is full to get rid of the waste. But when you have urinary retention, the bladder does not empty completely. A variety of things can cause the condition—.
A blockage—either in the outlet of the bladder or in the urethra through which the urine passes
Medicines used for other medical conditions
Nerve problems
Contents
- Definition Overview
- Diagnosis/Tests
- Management/Treatment
- Prevention
- Conclusion
- Clinical Staff
- Living With
Urinary retention refers to the difficulty of emptying your bladder all the way when passing urine. It can result from blockages, medications, or problems with nerves. Anatomically, the bladder exists as a holding place that stores pee filtered by the kidneys until release from the body through the urethra.
Urinary retention is the inability of the bladder to empty itself—fully or at all—after urination. Urine, a liquid waste product elaborated by the kidneys, flows through the ureters into the bladder, where it sits until it is excreted from the body. Urine leaves the body through the urethra. With urinary retention, the bladder won't empty properly, leading to potential pain and health complications.
Urinary retention can be acute or chronic. Acute urinary retention comes on rapidly and thus is the most distressing; it is a medical emergency in most cases. Chronic retention, by contrast, develops more insidiously. The most common category affected is that of individuals AMAB from 60 to 80 years of age, although it may also occur in people AFAB.
About 10% of persons AMAB over the age of 70 and up to 30% of those over 80 will develop urinary retention. While acute urinary retention is less common in persons AFAB, it still happens.
Symptoms and Causes
Signs of Urinary Retention
Symptoms vary depending on whether one considers the condition acute or chronic.
Acute Urinary Retention Symptoms
In acute cases, the symptoms come on suddenly. You may not even try to pass urine at all, or you may only pass a few dribbles of urine, despite having a full bladder. Severe chronic retention of urine can lead to digestive disturbances and lower abdominal pain and calls for emergency treatment.
Symptoms of Chronic Urinary Retention
The symptoms can take a gradual onset in chronic cases and may include the following:
- Strain when attempting to pee.
- A thin, slow, or uncontrollable flow of urine.
- Sensation to go for urination again just after peeing.
- Frequency of urination.
- Urinary incontinence.
- Nocturia.
Causes of Urinary Retention
A variety of factors may cause urinary retention, which includes an obstruction, medications, neurological disorders, infection, edema, and surgery.
Obstruction
The most common factors leading to obstruction to the free flow of urine from the urinary bladder and the urethra are:
- Benign prostatic hypertrophy: The prostate is abnormally increased in size and compresses the urethra in AMAB individuals.
- Obstruction of the bladder neck.
- Ureteral obstruction: This may be due to stones, blood clots, tumors, or other causes.
- Cystocele: Bladder prolapse into vagina
- Rectocele: Rectum prolapse into the vaginal wall
- Urethral stricture: Scar tissue narrows urethra
Medications
Some medications may cause urinary retention by affecting bladder muscle function. These include:
- Antihistamines Benadryl
- Antispasmodics Detrol
- Opiates Vicodin
- Tricyclic antidepressants Elavil
- Other medications that have
Urination is initiated by messages sent from the brain to the spinal cord to the bladder at the time the bladder muscles contract and the sphincter muscles relax. Nerve or nerve disorders associated with retention of urine. These may cause retention of urine. Included in this category are conditions involving;
- Stroke,
- Diabetes,
- Multiple sclerosis
- Trauma to the back
- Trauma to the pelvis
- Infections or swelling caused by;
Infection and inflammation may also affect the flow of urine in the urethra. Some causes include:
- Prostatitis: Inflammation or infection in the prostate.
- Urinary tract infection (UTI): Causes inflammation or weakness in the bladder.
- Sexually transmitted infections (STIs): Cause inflammation and hence difficulty voiding or emptying the bladder.
Surgery
Surgical retention can occur post-surgery, particularly in orthopedic surgeries and spinal surgeries. General anesthesia can also cause temporary urinary retention.
Risk Factors
It is more common in AMAB and especially if the prostate is enlarged (benign prostatic hyperplasia or BPH).
Complications
If left untreated, it can lead to:
- UTIs: Stagnant urine cultivates the growth of bacteria.
- Bladder damage: over time, the bladder muscles are overstretched
- Kidney damage: infection may enter the kidneys. Kidneys get inflamed and swell
- Urine leaks
- Bladder stones
Diagnosis and Tests
How is Urinary Retention Diagnosed?
Acute urinary retention is a medical emergency. Visit the health care provider's office or hospital if you suddenly cannot urinate, especially if you have abdominal pain.
For chronic urinary retentions, a urologist will;
Take your history and ask about your symptoms
- Carry out a physical.
- Collect a urine sample to test for infection.
- Perform a digital rectal examination to test the prostate.
Other exams and tests may include:
- Post-void residual urine test (PVR): A test done to measure the urine left in the bladder after urination.
- Cystoscopy: Looks at the bladder and urethra with a lighted tube equipped with a camera.
- Urodynamic testing: A test used to measure nerve and muscle function, bladder pressure, and urine flow rate.
- PSA test: A test used to screen for prostate cancer.
How is Urinary Retention Managed and Treated?
Treatment depends on whether it's acute or chronic, and on the underlying cause.
Acute Urinary Retention Treatment
With acute urinary retention, a catheter is immediately inserted to drain the bladder. This relieves discomfort quickly, and then the cause can be diagnosed and treated.
Chronic Urinary Retention Treatment
Treatment for chronic urinary retention includes medication, surgery, and nonsurgical approaches.
Medication
Medications may be directed at the cause, for example,
- Enlarged prostate: Alpha-blockers and 5-alpha reductase inhibitors.
- Infections: Antibiotics.
Surgery
Surgery might be needed for blockages or other problems that are causing urinary retention. That includes:
- Enlarged prostate: TURP, prostatic urethral lift, or HoLEP.
- Urethral stricture: Catheter or balloon dilation or urethroplasty.
- Cystocele or rectocele: Pessary or surgical repair.
- Urinary tract stones: Cystolitholapaxy.
Less invasive treatments are tried first. If these don't work, you might need to do a more invasive procedure.
- Kegel exercises or pelvic floor physical therapy.
- vaginal pessary to support the bladder.
- bladder control methods.
Prevention
Can You Prevent Urinary Retention?
While you can't prevent urinary retention completely, you can lower your risk by:
Urinating when you feel the need to, rather than resisting the urge to go.
Paying attention to urination habits and telling your healthcare provider if you notice any type of change in how you're going.
Staying at a healthy diet, weight, and hydration.
Outlook / Prognosis
Can You Still Urinate with Urinary retention?
Yes, with urinary retention some urine leakage may still occur. This may indicate incomplete emptying of the bladder or overflow incontinence.
What to Expect
One should follow through and allow the treatment plan and follow-up to be completed. Most people receive relief from symptoms with treatment.
- Living With Urinary Retention
- When to Seek Medical Care
- Call your health care provider if you have: frequent impulses to pee within a short span after peeing.
- Struggle or have difficulty in the initiation of urination, or your urine stream is weak.
- Have pain in your lower belly, testicles, or lower back.
Questions to Ask Your Healthcare Provider
Questions you can ask if you have urinary retention include:
- What is causing my symptoms?
- Do I need additional tests?
- What is the treatment that you recommend?
- Put in place ways to manage symptoms.
Is there a cure for my urinary retention?
PEEN: Bladder control issues can be difficult to talk about, but you are not alone. Common and treatable, urinary retention is a condition but if you notice any symptoms in your urine stream or cannot eliminate your urine, contact your health care provider. Many treatment options can help you relieve your symptoms and provide a cure to enhance your quality of life.
