Urinary retention is the inability to pass all the urine in your bladder. In some cases, you may not be able to pass any urine at all. This is known as acute urinary retention, which happens suddenly. If you have acute urinary retention, it is important to see a doctor right away.
If you’re unable to get an appointment with a urologist immediately, you should seek care at an emergency facility.
Urinary retention can also be chronic, or a long-term issue. For those with chronic urinary retention, it may be hard to start the flow of urine or have a weak flow after starting. Some may also feel the urge to urinate after completing since they aren’t completely emptying their bladder.
The chronic condition is most often found in older men, but can also occur in women.
Acute urinary retention requires immediate medical attention. Symptoms include:
- A complete inability to pass urine
- A painful urge to urinate
- Pain or swelling in your lower abdomen
Chronic urinary retention symptoms include:
- Frequent urination (more than 8 times per day)
- Trouble starting urination
- Weak or intermittent urination stream
- A feeling of needing to urinate after finishing urination
There are many different causes.
Blockage – In men, the urethra may be constricted by an enlarged prostate – a common condition for men over 50. In women, blockage can be caused by certain types of pelvic prolapse, including Cystocele (when the bladder falls into the vagina) and Rectocele (when the rectum/large intestine falls forward on the vagina).
Other blockage reasons for both men and women include urethral stricture and urinary stones.
Infection / Swelling – In men, prostatitis (prostate infection), can cause swelling that blocks the free flow of urine. Urinary Tract Infections and Sexually Transmitted Diseases can also cause swelling that leads to urinary retention.
Nerve Problems – Urinary retention could be caused by a problem with the nerves that control the bladder. If the nerves are damaged, it can cause a breakdown in the signals between the brain and bladder. Some causes of nerve damage include:
- Multiple Sclerosis
- Brain or spinal cord infections or injuries
- Herniated disc
- Vaginal childbirth
Medications – Some medications including antihistamines, decongestants, anticholinergics, and some muscle relaxing medications. If men already have BPH, taking these medications may increase the likelihood of urinary retention.
For acute urinary retention, your doctor will place a catheter into your urethra to drain the bladder.
Treatment for chronic urinary retention will depend on the root cause of the issue. To determine the root cause, your doctor may recommend:
- A physical exam
- CT Scan
- Urodynamic testing
- Post-void residual measurement
- PSA Blood Test (in men)
For chronic urinary retention due to BPH (Enlarged Prostate), your doctor may recommend medications to control the size of the prostate. In some cases, surgery to remove part of the prostate may be recommended. Other surgeries use steam to remove obstructing prostate material, or it’s held with small bands, allowing a greater flow of urine.
For women with pelvic prolapse as the cause, pelvic floor physical therapy may be recommended to strengthen the muscles that help control bladder function. A vaginal pessary may also be used to keep the bladder in place.
In cases of urethral stricture, there are two main treatment options: Urethral Dilation and Urethroplasty.
In cases of nerve damage, self-catheterization may be necessary.