Urinary retention is the body’s inability to completely empty the bladder — it can be classed as either acute or chronic.
Acute urinary retention — comes on quite suddenly and can cause great discomfort or pain. With acute urinary retention, a person cannot urinate at all (even if they have a full bladder) and is a potentially life-threatening medical condition requiring immediate emergency treatment.
Chronic urinary retention — can be a long-lasting medical condition. People with chronic urinary retention can urinate, but they cannot completely empty all of the urine from their bladders. Sometimes, a person is not aware they have this condition until other problems present like Urinary Incontinence, or a Urinary Tract Infection.
Urinary retention can affect anyone. However, men in their fifties and sixties are more susceptible, primarily because of an enlarged prostate.
A woman can also be affected by urinary retention if she suffered from a condition called Cystocele, where the bladder starts to sag or moves out of its normal position. It can also be pulled out of position when the lower part of the colon starts to sag — a condition called Rectocele.
Urinary retention can be attributed to two causes — either obstruction or non-obstruction.
If there is an obstruction (for example, bladder or kidney stones), a blockage occurs and urine cannot flow unimpeded through your urinary track. This is the basis for acute urinary retention and is potentially life threatening. You must seek immediate emergency treatment.
Non-obstructive causes include a weakened bladder muscle and nerve problems that interfere with signals between your brain and the bladder. If the nerves aren’t working properly, your brain may not get the message that the bladder is full.
Obstructive urinary retention causes include:
Common causes of non-obstructive urinary retention are:
Symptoms of urinary retention differ according to whether you’re suffering from Acute or Chronic Urinary Retention:
Acute urinary retention symptoms require immediate medical attention:
Chronic urinary retention symptoms may include
For acute urinary retention, the signs are often obvious. For example, you will be extremely uncomfortable, unable to pass urine and have a distended bladder. For chronic urinary retentions the diagnosis may only come after your doctor performs a series of tests. This is because some of the symptoms are shared with other conditions related to the bladder and urinary tract.
Very often, and especially in men, an enlarged prostate can be the culprit and treatment can begin accordingly. In these instances, doctors will rely on medical history and a physical examination to determine if urinary retention is a concern. They will also look out for more serious urinary retention causes, such as cauda equina or spinal cord compression.
Generally though, your doctor will diagnose acute or chronic urinary retention with a:
Additionally, they may use these tests to help determine the cause of urinary retention:
- Uroflowmetry — To measure urine speed and volume
- Pressure flow study — To measure the bladder pressure required to urinate and the flow rate a given pressure generates
- Video urodynamics — To create real-time images (using x-ray or ultrasound) of the bladder and urethra during the filling or emptying of the bladder.
Your doctor/specialist may treat your urinary retention with
The type and length of treatment will depend on the type and cause of urinary retention.
Bladder drainage is the use of a catheter to drain urine. Acute urinary retention treatment usually starts with catheterisation to relieve the distress of a full bladder and to prevent further bladder damage. Under local anaesthetic, a doctor passes a catheter through the urethra into the bladder where draining of urine can then begin. Sometimes a urethra can become blocked. If this happens, your doctor will administer anaesthesia, then insert a catheter through the lower abdomen, just above the pubic bone, directly into the bladder.
If other treatments for chronic urinary retention don’t work, you may require occasional or long-term catheterisation and will receive instruction from your doctor on how to self catheterise to drain urine when necessary.
Urethral dilation is used to treat urethral stricture. This is done by inserting increasingly wider tubes into the urethra, or inflating a small balloon at the end of a catheter inside the urethra. Both methods widen the stricture to allow an easier flow of urine. The procedure is usually performed under local anaesthesia, but in some cases you might receive sedation and regional anaesthesia.
Another treatment for urethral stricture involves inserting an artificial tube, called a stent, into the urethra to the area of the stricture. Stents may be temporary or permanent and once in place, expands like a spring and pushes back the surrounding tissue, widening the urethra.
Your doctor may prescribe one or a combination of medications to stop the growth of or shrink the prostate or relieve urinary retention symptoms associated with Benign Prostatic Hyperplasia (enlarged prostate).
Some complications of urinary retention and its treatments may include:
If you have an enlarged prostate, be sure to take prostate medications as prescribed by your doctor and avoid medications associated with urinary retention, such as over-the-counter cold and allergy medications that contain decongestants.
If you have mild cystocele or rectocele, you may be able to prevent urinary retention by doing exercises to strengthen the pelvic muscles.
Kimberly-Clark Singapore makes no warranties or representations regarding the completeness or accuracy of the information. This information should be used only as a guide and should not be relied upon as a substitute for professional medical or other health professional advice.
Healthdirect.gov.au, (2014). Urinary retention. [online] Available at: http://www.healthdirect.gov.au/urinary-retention [Accessed 5 May 2015].
http://www.health.qld.gov.au, (2015). Adult Urinary Obstruction, Retention and Bladder Scanning. [online] Available at: http://www.health.qld.gov.au/mass/docs/resources/continence/urinaryobstruct.pdf [Accessed 7 Apr. 2015].
John P. Cunha, F. (2014). Urinary Retention: Get the Facts on Causes and Treatment. [online] MedicineNet. Available at: http://www.medicinenet.com/urinary_retention/article.htm [Accessed 7 Apr. 2015].
Kidney.niddk.nih.gov, (2014). Urinary Retention - National Kidney and Urologic Diseases Information Clearinghouse. [online] Available at: http://kidney.niddk.nih.gov/kudiseases/pubs/urinaryretention/ [Accessed 7 Apr. 2015].
Knott, MD, L. (2015). Acute Urinary Retention. Information about AUR. Patient | Patient.co.uk. [online] Patient.co.uk. Available at: http://www.patient.co.uk/doctor/acute-urinary-retention [Accessed 7 Apr. 2015].
Medtronic.com.au, (2012). Urinary Retention - Urinary Retention Causes and Symptoms. [online] Available at: http://www.medtronic.com.au/your-health/urinary-retention/index.htm [Accessed 7 Apr. 2015].
SELIUS, DO, B. and SUBEDI, MD, R. (2007). Urinary Retention in Adults: Diagnosis and Initial Management - American Family Physician. [online] Aafp.org. Available at: http://www.aafp.org/afp/2008/0301/p643.html [Accessed 7 Apr. 2015].