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Urinary Retention

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Urinary retention means inability to pass urine completely as some amount gets retained in the urinary bladder. Although a person will feel the urge to urinate, he/she cannot either initiate urination smoothly or empty the bladder completely.

Urinary retention can be chronic and acute. In case of chronic urinary retention, the patient can pass urine but will experience problems with storing in and emptying from the bladder. Acute urinary retention is characterized by sudden inability to pass urine and it calls for immediate medical help.

Symptoms of urinary retention

Chronic urinary retention

  • Problem in starting urine
  • Weak flow of urine
  • Frequent urge to urinate
  • Urine infections
  • Post urination dribbling

Acute urinary retention

  • Inability to urinate, despite urgent need
  • Bloating of lower belly
  • Abdominal pain
  • Great deal of discomfort

Causes of urinary retention

Urinary retention is primarily caused either due to complication in bladder function or due to improper co-ordination of nervous signal between the bladder and the brain.

1.Neurogenic bladder: Damage of the nerves in the bladder can hinder normal contraction and relaxation required to excrete urine. It can also affect urethral function. The reasons are:

  • Vaginal childbirth
  • Brain, spinal cord and pelvis injury
  • Birth defects in spinal cord and nervous system
  • Diabetes, stroke, multiple sclerosis

2.Enlargement of prostate

3.Side effects of medicines for allergy, depression, urinary incontinence, muscle spasms, etc.

4.Stone in the bladder

5.Narrowing or closure of the urethra- urethral stricture

6.Urinary tract infection

7.Side effect of surgery

8.Bladder prolapse due to chronic cough, constipation, etc.

What are the complications of urinary retention?

Delay in treatment and prolonged retention of urine can lead to bladder damage and chronic kidney disease

Diagnosis of urinary retention

Your doctor shall initiate the diagnosis by enquiring several questions regarding your medical history and the tentative time since when you have been experiencing the problems. He/she will physically examine your lower belly.

Subsequently you might need to undergo a series of tests to complete the diagnosis. The tests include:

  • Urine sampling for detecting infections
  • Urodynamic test  to study the function of the bladder
  • X ray and CT scan of the urinary tract
  • Ultrasound of the bladder to check for post-void residual urine volume
  • Cystoscopy of the bladder and urethra
  • Blood test for prostate specific antigen to determine prostate problems

Treatment for urinary retention

There are several lines of treatment for restoring the function of the bladder which depend completely on the diagnostic test reports.

Antibiotics are prescribed for healing urinary tract infections. With this treatment, you can urinate normally again.

A catheter is inserted via the urethra to drain the bladder. It could be a short term treatment option or long term mostly in case of acute urine retention. American Urological Association (AUA) guidelines recommend conducting at least one trial of voiding the bladder post catheter removal before considering a surgery.

Prostate enlargement can be resolved either with medication or surgery. Similarly, the urethra is dilated with the help of tubes or stents to heal urethral strictures.

Surgery is one of the major lines of treatments for stones and fallen bladder. Urinary diversion may be done when other treatments fail to normalize urine excretion.

Can urine retention be prevented?

You can reduce your chances of becoming vulnerable to bladder problems when you keep your system hydrated regularly. Drink plenty of water while cutting down on caffeinated beverages. Secondly, practise proper hygiene, especially while using public toilets to avoid contracting UTIs.

Urinary retention under any circumstance should not be neglected. Check up with your doctor whenever you experience trouble in passing urine.

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Written by: Saptakee sengupta
Date last updated: January 29, 2015

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