Your urinary tract is a complex system that helps your body filter, drain, and remove the waste product urine. In a healthy person, all parts of the urinary tract work together properly and urine is produced without problems. The kidneys involuntarily filter blood and then paste the urine through ureters and into the bladder. When the bladder fills up, it sends a signal to the brain telling you that it’s time to find a bathroom and empty your bladder. When it comes time to actually urinate, your bladder tightens and releases the waste product out through the urethra. In healthy individuals, the bladder is emptied completely. However, for a number of different reasons, sometimes the bladder doesn’t empty completely. This is called urinary retention. In this article, we’ll explore what urinary retention is in more detail, how to prevent it, and how to treat it.
What is Urinary Retention?
Urinary retention, or the inability to empty your bladder completely, can be caused by a number of different factors. It can also happen suddenly and for a very short time, or be a long-lasting medical condition.1 When you suffer from urinary retention, you will feel like you have to urinate more often, though won’t be able to find complete relief from going to the bathroom.2 In other cases of urinary retention, it may be difficult to start urinating.3
Chronic Urinary Retention
Chronic urinary retention is a long-lasting medical condition that tends to form over many months or years.4 It’s a gradual progression that usually worsens over time. Chronic urinary retention in adults is marked by symptoms including the following:4
- Difficulty urinating
- Feeling the urge to urinate again after using the bathroom
- Weak or interrupted urine stream
- Urinating frequently within a short period of time
- Using the bathroom more than 8 times a day, regardless of liquid intake
- Straining while urinating
- Not noticing the sensation to urinate
- Incontinence
Acute Urinary Retention
Acute urinary retention is considered more serious than a chronic retention, as it occurs suddenly and often as a result of a medical emergency.4 More often than not, acute urinary retention occurs from a blockage of a part of the urinary tract system, which needs to be addressed quickly to ensure complications don’t ensue.4 Some symptoms of acute urinary retention include the following:4
- A complete inability to urinate
- Swelling or stomach pain
- Feeling like your bladder is full
- An intense need to urinate
- Fever
- Chills
If you notice any signs of acute urinary retention, it’s important to seek medical treatment as soon as possible to get the underlying issue addressed.
Causes of Urinary Retention
While urinary retention affects both men and women, it tends to occur more frequently in men—up to 10 times more often.2 As with most urinary problems, the older a person gets, the more likely they are to experience urinary retention. In addition to gender and age, some of the main causes of urinary retention are due to the obstruction of the urethra. This can occur because of a number of different reasons.
- Benign Prostatic Hyperplasia
- Urethral Stricture
- Urinary Tract Stones
- Cystocele
- Rectocele
- Constipation
- Tumors or Cancerous Tissue
Urinary retention may also be caused due to problems with the nerves that have control over the bladder and sphincters.1 The reason this causes urinary retention is due to an interruption in signaling from the bladder to the brain—communication is hindered and therefore the bladder doesn’t get the signal to fully empty. Common causes of nerve problems that can cause urinary retention include:1
- Vaginal Childbirth
- Diabetes
- Stroke
- Multiple Sclerosis
- Pelvic Injury
- Pelvic Trauma
- Brain or Spinal Cord Infections
- Brain or Spinal Cord Injuries
- Heavy Metal Poisoning
- Spina Bifida
- Post Surgery—while anesthesia is still in effect
Certain medications may also cause men or women to experience mild urinary retention symptoms. Some of the medications that cause the worst symptoms include antihistamines, anticholinergics/antispasmodics, tricyclic antidepressants, decongestants, nifedipine, carbamazepine, cyclobenzaprine, diazepam, nonsteroidal anti-inflammatory drugs, amphetamines, and opioid analgesics.1 Talk to your doctor if you are taking any of these medications and experience severe signs and symptoms of urinary retention.
There are also a few causes of urinary retention that are gender specific. In men, those who suffer prostate problems are more likely to experience urinary retention.2 If a man is uncircumcised, there are a few things that can lead to obstruction causing urinary retention such as paraphimosis and phimosis.2 In women, vulvovaginitis and prolapse can lead to urinary retention.2
Diagnosing Urinary Retention
If you’re experiencing any signs or symptoms of urinary retention, it’s important to schedule a visit with your urologist and get properly diagnosed. Getting a medical diagnosis is the only way to understand what’s causing urinary retention and therefore treat it. Luckily, diagnosing urinary retention is usually simple and straightforward. In most cases, your doctor will be able to confirm urinary retention by the symptoms present and a physical exam that includes your genitals and rectum.2
If your doctor needs more information about your urinary retention, there are a number of tests that can be done. They include:2
- Urine Sampling
- Blood Sampling
- Cystoscopy
- Ultrasound
- CT Scan
- Post-Void Residual (PVR)
- Urodynamic Tests
- Electromyogram
How to Treat Urinary Retention
The treatment of urinary retention is different based on whether or not it’s acute or chronic. Since acute urinary retention is considered a medical emergency, a catheter will be inserted to empty the bladder.2 Once your bladder has been emptied, your doctor will work with you to find the underlying cause and treat it. If you’re suffering from chronic urinary retention and it starts to negatively affect your life, there are a number of options that your doctor will suggest.
Behavioral Modification
One of the first things your doctor will suggest is making slight behavior modifications. If you have more bladder control, you’ll be better able to manage your urinary retention issues. Some things you can do include managing the amount of fluids you intake and adjust the times you drink fluids, strengthen your pelvic muscles, and practice bladder retraining exercises.2
Catheterization
Using intermittent self-catheterization will help you fully empty your bladder while your doctor works on treating the underlying cause. Intermittent self-catheterization can be done at home after your doctor shows you how. Just make sure to practice clean intermittent self-catheterization techniques.
Urethral Dilation and Stents
Urethral dilation widens the urethral stricture gradually so that your body can pass more urine and empty the bladder.2 It is done using tubes of increasing widths or by inserting a tube with a balloon and then inflating the balloon.2 A Urethral stint is a small tube that widens as it opens and can also help to up your urethral stricture.2
Medications
Depending on the cause of urinary retention, your doctor will prescribe one or more medications to help. Antibiotics are given if you have urinary tract infections or other infections. There are also medications available to help relax your urethral sphincter and prostate for a better urine flow and medications that reduce the size of your prostate to reduce any obstructions currently placed on the urethra.2
Surgery
If all else fails, your doctor may recommend surgery to treat your urinary retention. There are a number of different outpatient procedures that can be done, most of which are minimally invasive. You can learn more about the surgical options for urinary retention here.
Conclusion
Urinary retention is a condition that plagues millions of adults, but it doesn’t have to control your life. If you’re struggling from one or more of the symptoms of urinary retention, schedule a visit with your urologist today. Getting treatment is important to ensure that you don’t deal with annoying interruptions to daily life. Diagnosis is also important in case of infection from an underlying medical cause—which can spread when left untreated. In the meantime, if you need any urological supplies or additional educational resources, visit our educational support page or our product selection guide. Byram Healthcare is proud to offer full-service urological care and we have all the high quality urological supplies that you need. If you need to order any urological supplies, all of your orders can be delivered to your residence, at any time of the day. If you have any urological questions or need personalized, confidential services, our team of knowledgeable urological customer service specialists are here to help.
Sources:
1https://www.niddk.nih.gov/health-information/urologic-diseases/urinary-retention
2https://www.healthline.com/health/urinary-retention
3https://www.medtronic.com/uk-en/patients/conditions/urinary-retention.html
4https://www.medicalnewstoday.com/articles/327417.php#symptoms
