Urinary Retention

What is Urinary Retention?

Urinary retention occurs when your bladder does not empty fully — or at all. This can be caused by an obstruction in the urethra that affects the flow of urine or by a weak bladder muscle that doesn’t work properly.

Sudden inability to void your urine can be a medical emergency, and you should immediately consult a healthcare professional. For most people, urinary retention is a chronic condition. It’s important to see your doctor if you have ongoing issues with urinary retention, because if your bladder doesn’t properly eliminate urine, it can be more susceptible to developing infection.

Men with enlarged prostate are more likely to face chronic problems with urinary retention. For women, the most common cause of urinary retention is a bladder prolapse which can put pressure on the urethra. Other causes include diseases that affect the central nervous system like Parkinson’s or Multiple Sclerosis, or taking certain types of medication that weaken the bladder muscle.

What are the Symptoms of Urinary Retention?

You may not have obvious signs of urinary retention, especially if it is a chronic issue that has subtly worsened over time.

You may have an increasingly harder time starting the flow of urine or be unable to pass more than a small amount of urine, even when you feel like you have more in your bladder. The flow of urine may be weak or may stop and start repeatedly.

Urinary Retention Causes

Urinary retention may be caused by a wide variety of ailments, conditions, procedures, and medications. Benign prostatic hyperplasia or an enlarged prostate can lead to it. Urethral stricture, or narrowing or closure of the urethra caused by a range of diseases, injuries, or urinary tract infections (UTIs), and surgeries, may cause urinary retention. In particular, surgeries addressing injuries to the penis or treating benign prostatic hyperplasia or prostate cancer can generate scarred tissue or inflammation leading to a narrowing of the urethra. Because men generally have longer urethras than women, they face increased risk of urinary retention via urethral stricture.

Urinary tract stones, or crystals which form in urine and build up in the kidneys, ureters, or bladder, risk becoming stuck in the bladder, blocking the passage to the urethra.

Pressure placed upon the bladder or urethra because of hard, large stools caused by constipation or because of growing tumors or cancerous material may also create urinary retention.

In women, cystocele or rectocele, which are, respectively, bulging of the bladder and the rectum against the vagina, may deform and constrict the passageways of the urethra, thereby causing urinary retention as well.

Nerve damage caused by a variety of conditions, diseases, medications, and poisons may also disrupt the brain’s ability to properly receive the signal that the bladder is full. As a result, the bladder muscles needed to push urine out may not receive their needed signals from the brain.

Common medications associated with urinary retention or nerve interference leading to urinary retention include antihistamines, anticholinergics and antispasmodics, tricyclic antidepressants, decongestants, amphetamines, diazepam, and others.

Additionally, as people age, their bladder muscles may weaken so that they cannot contract strongly enough to force out all urine. Because of this, risk for urinary retention generally increases as people age, with a spike in risk for seniors.

How is Urinary Retention Treated?

The best treatment for urinary retention depends on the cause. For acute and emergency cases, a catheter can be inserted to open the urethra, drain the bladder and reduce the pressure.

An enlarged prostate can be treated with drugs to shrink the gland; this will reduce the pressure on the urethra. Women with bladder prolapse may be able to do certain exercises that will strengthen the pelvic floor, but severe cases will require surgery.

Urinary Retention Prevention

Preventing urinary retention often involves treating broader conditions for which it is a symptom. For example, seeking treatment for an enlarged prostate or prostate cancer, among other cancers that affect the pelvic region, may prevent or alleviate urinary retention. When consulting health professionals, one should ask about avoiding medications associated with urinary retention as well as asking about medical procedure and operations which may cause scarring or inflammation that leads to urethral stricture.

A healthy lifestyle and a diet high in fibers, as well as certain medications, can help prevent urinary retention caused by constipation.

Treating and preventing injuries and diseases such as nerve diseases, strokes, and spinal cord and pelvic injuries can also prevent urinary retention from occurring.

For women, vaginal childbirth often causes urinary retention. One may consult with medical professionals in order to prevent it in this case. Women with cystocele or rectocele can perform exercises to strengthen their pelvic muscles, such as kegel exercises, in order to avoid urinary retention.