Urinary retention is a medical condition where an individual experiences difficulty or complete inability to empty their bladder. This can range from a sensation of incomplete voiding to a painful, sudden inability to urinate. Addressing this issue is important as it can lead to discomfort and serious health complications if left unmanaged.
What is Urinary Retention?
Urinary retention is the inability to completely empty the bladder. It has two primary forms: acute and chronic. Acute urinary retention is a sudden, complete inability to pass urine, often with severe lower abdominal pain and a strong urge. It develops rapidly, requiring immediate medical attention.
Chronic urinary retention develops gradually. Individuals can still urinate but cannot fully empty their bladder, leaving significant urine behind. This incomplete emptying can cause frequent urges, persistent fullness, or a weak, interrupted stream, potentially leading to complications.
Common Reasons for Difficulty Urinating
Urinary retention can stem from factors interfering with bladder storage or release. Obstructions in the urinary tract are a common cause, physically blocking urine flow. In men, an enlarged prostate (benign prostatic hyperplasia or BPH) frequently compresses the urethra. Bladder stones or tumors can also create blockages. For women, pelvic organ prolapse, where organs like the bladder or uterus descend and press against the urethra, can impede urine flow.
Nerve problems controlling bladder function can lead to retention. Conditions like stroke, spinal cord injury, multiple sclerosis, or Parkinson’s disease can disrupt brain-bladder communication, preventing proper emptying. Diabetes, through nerve damage (neuropathy), can also affect bladder function. Certain medications are another cause, acting as side effects that interfere with bladder muscle contraction or sphincter relaxation, including antihistamines, decongestants, antidepressants, and anticholinergic drugs.
A weakened bladder muscle, often due to aging or prolonged overstretching, may lose its ability to contract effectively. Infections and severe inflammation (e.g., UTI) can cause swelling and irritation, temporarily making urination difficult. Anesthesia and certain pain medications after surgery can also temporarily impair bladder function, leading to post-operative urinary retention.
When to Get Medical Help
Recognizing when to seek medical attention for urinary difficulties is important. A sudden, complete inability to urinate, especially with severe lower abdominal pain, is a medical emergency. Acute cases require immediate attention, often an emergency room visit, to relieve bladder pressure and prevent damage.
For chronic urinary retention, where the inability to empty the bladder fully develops gradually, a doctor’s visit is warranted. Symptoms include a persistent feeling of incomplete emptying, a weak or interrupted urine stream, or increased urination frequency. Recurrent urinary tract infections can also indicate underlying bladder emptying issues. These symptoms signal a need for medical evaluation to identify the cause and prevent long-term problems.
Other concerning symptoms accompanying urinary difficulties should prompt a medical consultation. These include fever or chills (indicating infection) or visible blood in the urine. Severe abdominal pain with urinary issues also requires prompt medical assessment. Addressing these signs early helps ensure timely diagnosis and management.
How Doctors Diagnose and Treat It
Doctors use several methods to diagnose urinary retention and determine its cause. Initial steps include a physical examination and detailed medical history, asking about symptoms, medications, and past health. A bladder scan, using ultrasound, commonly measures post-void residual volume (urine remaining after urination).
Blood and urine tests check kidney function and detect infections or abnormalities. Specialized tests, like urodynamic studies, assess bladder and urethra function. Imaging techniques like ultrasound or CT scans visualize the urinary tract to identify structural issues.
Treatment for urinary retention primarily focuses on immediate relief and addressing the root cause. For immediate relief, especially in acute cases, catheterization often drains urine from the bladder by inserting a thin, flexible tube through the urethra. Depending on the cause, medications may be prescribed; for example, alpha-blockers can relax prostate muscles in men with BPH, while other drugs address bladder muscle dysfunction.
Lifestyle changes, such as timed voiding schedules, can encourage regular bladder emptying. For some, self-catheterization may be necessary for long-term management. When retention is due to structural issues, procedures or surgery may be required, including surgery to reduce an enlarged prostate, repair urethral strictures, or correct pelvic organ prolapse. The goal is to restore normal bladder function and prevent future complications.