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Urinary Retention

Urinary retention happens when a person cannot completely empty their bladder, even when they feel the urge to urinate and are trying to empty their bladder. The kidneys filter waste and pass it into the bladder through tubes called the ureters. This waste becomes urine in the bladder. The bladder holds it until the bladder is full. At this point, a healthy bladder passes urine out of the body via the urethra, a tube that carries urine out of the body.

Urinary retention can be classified as sudden (acute) or ongoing (chronic). When urinary retention comes on suddenly, it’s usually a sign of another health problem that should be addressed. It’s important to see a doctor as soon as possible. Chronic urinary retention is common in the older population, but most commonly in men due to an enlarged prostate.

Symptoms

The acute and chronic forms of urinary retention share some symptoms, but people living with chronic urinary retention experience a variety of symptoms. The two symptoms associated with sudden urinary retention are the inability to urinate at all or only being able to urinate in very small amounts. If you experience either of these symptoms and you have no history of urinary retention, it’s important to seek medical attention.

People living with long-term urinary retention may experience the inability to go or the ability to go in only small amounts, despite having a full bladder. Other symptoms include:

  • A weak flow of urine
  • Frequent urination
  • Constant urge to urinate
  • Abdominal pain

Causes & Risk Factors

There is no single cause for urinary retention. It can happen for a variety of reasons. These include:

  • A blockage in the urethra or pressure on the urethra
  • Certain medications
  • Neurological issues
  • Infections
  • Surgery

Age and sex are the primary risk factors. Urinary retention is more likely to happen as one gets older, and being assigned male at birth makes you more likely to get acute urinary retention as you age.

Diagnosis & Complications

A physical examination and an in-depth medical history are the primary tools your doctor will use to start forming a diagnosis. Based on how long you’ve been experiencing symptoms and the findings of the physical exam, your doctor may run one or more of these tests to confirm the diagnosis and cause of urinary retention.

  • Ultrasound of the bladder – this is done right after urinating to see if you are completely emptying the bladder
  • Urinalysis – an analysis of your urine for infectious disease or blood
  • Cystoscopy – a tiny tube with a camera on the end of it is put into your urethra to see if there are any blockages
  • Urodynamic testing – measures how quickly you urinate and how much urine you expel at once
  • EMG – an electromyography (EMG) uses gentle nerve stimulation to measure nerve function in the bladder
  • Lab testing – your doctor may want to test your blood for proteins associated with prostate cancer if they find abnormalities during a rectal exam

Complications of urinary retention include:

  • Urinary tract infection (UTI)
  • Kidney damage
  • Urinary incontinence (accidental release of urine)
  • Bladder damage

Treatment & Management

Acute urinary retention is treated with the placement of a catheter, a tube used to drain the bladder. Chronic urinary retention is treated in a variety of ways based on the cause. These include medications for a swollen prostate and surgeries for a swollen prostate. If the urethra has been narrowed, that can be treated with a balloon catheter, a tube with an inflatable tip that can open narrow passages. Alternatively, surgery can be done.

Women with urinary retention that have experienced the rectum or bladder collapsing into the tissues that support the vagina may be treated with pelvic exercises to strengthen the muscles. There is also the option to have a ring called a vaginal pessary placed in the vagina to support it, as well as oestrogen therapy and surgery.

 
 
 

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