Nephrology
One of the common causes of urinary retention is blockage of the urethra (a tube through which the bladder empties itself). In men, this often occurs due to a condition known as benign prostate hyperplasia (BPH). In this condition, the prostate gland becomes so enlarged that it puts pressure on the urethra and blocks the urine passage. Urinary stones, strictures, constipation, blood clots, or a tumor can also cause blockage of the urethra in both males and females.
Certain medications can weaken your bladder muscles, which can cause urinary retention. These medications include antihistamines, antispasmodics, antidepressants, opiates, anticholinergics, muscles relaxants, and amphetamines. Medicines used to treat urinary incontinence may also cause urinary retention as a side effect.
Other causes of urinary retention include nerve-related issues such as stroke, diabetes, Parkinson’s disease, multiple sclerosis, vaginal birth, or pelvic injury. Certain infections, inflammatory diseases, and surgical procedures of the lower abdomen can also lead to this problem.
There are two types of urinary retention: Acute and chronic.
Acute urinary retention develops at once and causes extreme pain and discomfort to the affected person. You may not be able to pass urine at all in this condition.
Chronic urinary retention develops over a long period of time. If it is mild, you will be able to pass urine but not completely. BPH is the most common cause of chronic urinary retention in men.
A major risk factor for urinary retention is age. Men over the age of 50 are at a higher risk of developing urinary retention due to BPH or medications. If you are taking specific medications such as those mentioned above, you may develop this problem at some point. People with neurological diseases are also at risk. Long-duration surgeries, use of regional anesthesia, or history of previous pelvic surgery can also put you at risk. In pregnant females, certain factors during pregnancy and labor may lead to urinary retention after delivery.
Urinary retention can occur in anyone, but it is predominant in men, especially those over the age of 50. With increasing age, the risk of this condition increases.
Acute urinary retention can present with the sudden inability to empty your bladder. You will be able to feel a strong urge to urinate, but you won’t be able to pass it. This can increase discomfort and may put pressure on your surrounding organs. In chronic urinary retention, you may have difficulty initiating urination or feel unable to pass urine completely. Due to this condition, your bladder will feel full again after a short interval, and you will have to go to the toilet multiple times. This can also cause sleep disturbance at night.
The first step towards diagnosis is history and examination. Your doctor will ask necessary questions to obtain a relevant history of your problem. This is followed by a physical examination of the genitals and rectum to suspect any possible causes. Necessary lab tests may include urinalysis, blood tests, urodynamic testing, cystoscopy, post-void residual urine (PVR), electromyography (EMG), ultrasound of the bladder, CT scan, or prostate-specific antigen test (PSA). Confirmatory diagnosis will be made on the basis of these lab tests results.
Urinary retention itself is a symptom of an underlying cause. The possible cause should be differentiated on the basis of a complete history, symptoms, physical examination, and diagnostic tests.
Treatment of urinary retention depends on its cause. In cases of acute urinary retention, a catheter needs to be placed inside the urethra to allow drainage of urine. If it is difficult to insert a catheter, a suprapubic catheter will be inserted to drain urine. In a chronic case, catheters are only used if a patient is completely unable to pass urine. However, it is not a long-term solution. Medicines or surgery will be required to treat the underlying cause of chronic urinary retention. Some lifestyle changes can also improve your condition. These include a drinking schedule, pelvic floor exercises, and exercises to control an overactive bladder.
If you are diagnosed with an infection that is causing urinary retention, your doctor will prescribe specific antibiotics to treat it. BPH can also be treated to a certain extent by medications such as alpha-blockers and 5-alpha reductase inhibitors. In some nerve-related causes, specific drugs will be given to improve the functioning of your bladder.
Majority of the cases of urinary retention can be treated well if treatment instructions are followed. Geriatric patients may have a recurrent problem even if they get treated once.
There are no particular preventive measures for urinary retention. You can reduce the risk of urinary retention by maintaining a proper fluid level, balanced diet, and passing urine whenever you feel the urge. Avoid withholding urine for an extended period. Pelvic floor exercises can also help to facilitate proper emptying of your bladder.
Our clinical experts continually monitor the health and medical content posted on CURA4U, and we update our blogs and articles when new information becomes available. Last reviewed by Dr.Saad Zia on April 29th, 2023.
https://www.emed.theclinics.com/article/S0733-8627(19)30069-0/fulltext
https://my.clevelandclinic.org/health/diseases/15427-urinary-retention
Urinary retention refers to the partial or complete inability to pass urine despite having a full bladder. You will feel the urge to urinate even after urinating a certain volume of urine. This is because your bladder is unable to empty itself completely due to multiple reasons. In many cases, it occurs due to an obstruction or blockage of the passage by which urine is expelled. Urinary retention can cause mild to severe discomfort. Hence you need to get it checked by a doctor for a possible underlying cause.