Urinary Retention: Causes, Diagnosis & Treatment

Urinary retention is a medical condition where the bladder does not empty, affecting many individuals worldwide. While some cases may resolve with treatment, chronic urinary retention can lead to severe complications if left untreated. If you’re experiencing symptoms of urinary retention, contact Pristyn Care to consult with top urologists who specialise in advanced treatments. Book your appointment today for expert care and a comprehensive treatment plan tailored to your needs.

What is Urinary Retention?

Urinary retention is a medical condition characterized by the inability to fully empty the bladder. The urinary retention meaning can be understood in two forms: acute and chronic. Acute urinary retention occurs suddenly, leading to a complete inability to urinate, often accompanied by significant pain and the need for urgent medical attention. 

In contrast, chronic urinary retention develops gradually, allowing some urination but never completely emptying the bladder. This chronic form may result in mild symptoms such as frequent urination, weak urine flow, or a constant urge to urinate even after using the bathroom.

What Causes Urinary Retention?

Urinary retention can stem from a variety of underlying causes, which can broadly be categorised into issues affecting bladder muscle function or obstructions within the urinary tract:

• Obstructive Causes:
  • Enlarged prostate: Often seen in older men, this can press against the urethra, inhibiting urine flow.
  • Urethral stricture: Scar tissue in the urethra that narrows the passage and blocks urine flow.
  • Cystocele: Bulging of the bladder into the vagina, common in women, affecting urine flow.
  • Urethral or bladder stones: Hardened mineral deposits that can block the urinary tract.
  • Urethral foreign bodies.
• Neurological Causes:
  • Spinal cord injuries or diseases like multiple sclerosis and Parkinson’s disease can disrupt nerve signals that coordinate the act of urination.
  • Diabetes and heavy metal poisoning can affect peripheral nerves, including those controlling the bladder.
• Other Causes:
  • Infections such as UTIs or prostatitis can lead to swelling and irritation that impedes urine flow.
  • Medications like antihistamines, antidepressants, and certain pain relievers can also cause or aggravate urinary retention.
  • Post-surgical effects, particularly those involving anaesthesia, can temporarily disrupt the ability to urinate​.

The comprehensive understanding of urinary retention causes aids in effectively recognizing and addressing this condition to prevent complications such as urinary tract infections and bladder damage.

Types of Urinary Retention

Urinary retention can present in several forms, each with distinct causes and implications. Recognising these types is essential for effective diagnosis and treatment.

• Acute Urinary Retention: This type of urinary retention occurs suddenly and is often a medical emergency. It involves a complete inability to urinate, leading to severe discomfort and pain. Immediate intervention is required to relieve the bladder and prevent complications.
• Chronic Urinary Retention: Chronic urinary retention develops gradually over time. It is characterised by the bladder not fully emptying during urination. This condition can be less obvious and may go unnoticed for a while, leading to long-term complications such as bladder damage.
• Obstructive Urinary Retention: This type results from a blockage within the urinary tract, such as an enlarged prostate, kidney stones, or strictures in the urethra. These obstructions prevent the normal flow of urine, causing retention.
• Neurogenic Urinary Retention: Caused by nerve-related issues, neurogenic urinary retention occurs when there is a disruption in the signals between the brain and bladder. Conditions like multiple sclerosis, spinal cord injuries, or Parkinson’s disease can lead to this form of retention.
• Postoperative Urinary Retention: This temporary form of urinary retention may occur after surgery, particularly those involving anaesthesia or pelvic procedures. It usually resolves once normal bladder function returns, but it may require short-term management​.

Symptoms of Urinary Retention

Urinary retention symptoms can vary depending on whether the condition is acute or chronic:

1. Inability to Urinate (Acute): The most alarming symptom, especially in acute cases, is the complete inability to pass urine despite a full bladder. This results in severe lower abdominal pain and requires immediate medical attention.
2. Frequent Urination (Chronic): Those with chronic retention may feel the need to urinate frequently, often in small amounts, due to incomplete bladder emptying.
3. Weak Urine Stream: A weak or slow urine flow is common in chronic urinary retention. This can be due to an obstruction or weakened bladder muscles.
4. Feeling of Incomplete Bladder Emptying: Many individuals feel as though they haven’t fully emptied their bladder after urination, leading to repeated trips to the bathroom.
5. Straining to Urinate: Some people may find they need to strain or push to start or maintain urine flow, which can be uncomfortable and frustrating.
6. Lower Abdominal Discomfort: Discomfort or pain in the lower abdomen can occur due to the bladder being overly full, particularly in chronic cases.

Diagnosis and Evaluation of Urinary Retention

Diagnosing urinary retention involves several steps to identify the underlying cause:

• Medical History and Physical Examination: The doctor will begin by reviewing the patient’s medical history and performing a physical examination. This includes assessing the lower abdomen for signs of bladder distension and, in men, a rectal examination to check for an enlarged prostate.
• Post-Void Residual (PVR) Test: This test measures the amount of urine left in the bladder after urination. It is typically done using an ultrasound or by catheterisation, which helps determine whether the bladder is emptying properly.
• Urodynamic Tests: These tests assess bladder function by measuring pressure and urine flow. They help identify issues with bladder muscles or nerve signals.
• Imaging Studies: Ultrasound, CT scans, or MRI may be used to visualise the urinary tract, identify blockages, or assess the bladder and surrounding organs for abnormalities​.

How the Urinary Retention Can be Treated?

The treatment of urinary retention depends on whether it is acute or chronic and the underlying cause:

• Catheterisation: In cases of acute urinary retention, immediate relief is provided by inserting a catheter to drain the bladder. This is often the first line of treatment to prevent bladder damage and ease discomfort.
• Medications: For chronic cases, medications may be prescribed to address the underlying cause. For instance, alpha-blockers can relax the muscles around the bladder neck and prostate, improving urine flow. Additionally, 5-alpha reductase inhibitors can reduce prostate size in men with benign prostatic hyperplasia (BPH).
• Surgery: In situations where an obstruction, such as an enlarged prostate or urethral stricture, is causing the retention, surgery might be required. Procedures such as transurethral resection of the prostate (TURP) or urethral dilation can alleviate the blockage.
• Lifestyle Adjustments: In some cases, lifestyle changes, including fluid management and timed voiding, may help manage symptoms, particularly in chronic urinary retention.

Each treatment option is chosen based on the individual’s condition and the specific cause of their urinary retention.

When is Urinary Retention Considered Serious?

Urinary retention can be a serious condition that requires immediate medical attention. It is essential to recognise when the situation becomes critical to prevent complications.

• Complete Inability to Urinate: If you suddenly cannot pass any urine, this is a medical emergency. The bladder can become painfully distended, leading to potential bladder damage or kidney problems.
• Severe Pain in the Lower Abdomen: Intense pain accompanied by an inability to urinate indicates acute urinary retention, which needs urgent intervention to prevent serious complications.
• Associated Symptoms of Infection: If urinary retention is accompanied by fever, chills, or pain, it may indicate a urinary tract infection (UTI) or kidney infection, both of which require prompt treatment.
• Chronic Retention with Bladder Damage: Ongoing issues with incomplete bladder emptying can lead to bladder damage, urinary incontinence, or kidney damage over time. Persistent symptoms should be evaluated by a healthcare provider to avoid long-term complications​.

Prevention of Urinary Retention

Preventing urinary retention depends largely on managing the underlying causes and maintaining good urinary health. While some causes cannot be prevented, you can reduce the risks associated with this condition:

• Regular Medical Check-ups: Regular screenings for conditions like benign prostatic hyperplasia (BPH) in men and pelvic organ prolapse in women can help detect issues early before they lead to urinary retention.
• Medication Review: If you are on medications known to affect bladder function, such as antihistamines or decongestants, discuss alternatives or adjustments with your doctor.
• Stay Hydrated and Manage Fluid Intake: Adequate hydration supports bladder function, but avoiding excessive fluid intake at night can help manage symptoms, particularly for those with chronic retention.
• Consult the Right Specialist: If you experience any symptoms of urinary retention, it is crucial to consult a urologist or your general practitioner promptly. Early diagnosis and treatment can prevent the condition from worsening.

Myths and Facts About Urinary Retention

Urinary retention is a condition surrounded by many misconceptions that can lead to confusion and delayed treatment. Understanding the myths and facts about urinary retention is crucial for managing the condition effectively and seeking the right care.

• Myth: Urinary retention only affects older men.
  • Fact: While it is more common in older men, urinary retention can affect anyone, including women and younger individuals, depending on the cause.
• Myth: Drinking less water can prevent urinary retention.
  • Fact: Inadequate hydration can actually worsen urinary retention. Drinking enough water is essential for maintaining healthy bladder function.
• Myth: Urinary retention is always caused by an enlarged prostate.
  • Fact: While an enlarged prostate is a common cause in men, urinary retention can result from a variety of issues, including neurological conditions, infections, and medications.
• Myth: Urinary retention is not a serious condition.
  • Fact: Untreated urinary retention can lead to severe complications such as kidney damage, bladder damage, and urinary tract infections, making timely medical attention crucial.

When to Consult a Doctor for Urinary Retention?

You should consult a doctor if you experience difficulty urinating, a frequent need to urinate without much output, or any pain in the lower abdomen. If you suddenly find yourself unable to urinate at all, seek immediate medical attention, as this is a medical emergency. It’s advisable to consult a urologist, a specialist in urinary tract conditions, who can provide a thorough evaluation and appropriate treatment. 

Visiting a specialist is essential because urinary retention can have various underlying causes, and expert diagnosis is crucial to preventing long-term complications​.

Questions to Ask Your Doctor About Urinary Retention

1. What is causing my urinary retention?
2. Are there any lifestyle changes I can make to improve my symptoms?
3. What treatment options are available for my condition?
4. How can I prevent urinary retention from recurring?
5. Will I need surgery, and what are the risks involved?
6. Are there any medications that could help, and what are their side effects?
7. How often should I have follow-up appointments to monitor my condition?
8. What are the potential complications if my condition is left untreated?

These questions help ensure that you fully understand your condition and the available treatment options, leading to better management and outcomes​.

FAQs

Q1. Can urinary retention be cured completely?

Treatment for urinary retention depends on the underlying cause. Some cases can be managed effectively with medication or surgery, while others may require ongoing treatment. Chronic conditions might not be completely cured but can be managed to improve quality of life.

Q2. Is urinary retention painful?

Acute urinary retention is often very painful, causing severe discomfort in the lower abdomen due to a full bladder. Chronic urinary retention may be less painful but can lead to ongoing discomfort and complications if not treated.

Q3. Can stress cause urinary retention?

Yes, stress can contribute to urinary retention, particularly in people with an overactive pelvic floor or anxiety-related muscle tension. Stress alone is unlikely to be the sole cause but can exacerbate existing issues.

Q4. How is urinary retention diagnosed in women?

Diagnosis in women involves a pelvic exam, bladder scan, and urodynamic tests. Imaging studies, such as ultrasounds, may also be used to identify any structural issues or blockages affecting the bladder or urethra.

Q5. Can urinary retention lead to kidney damage?

Yes, untreated urinary retention can cause urine to back up into the kidneys, leading to hydronephrosis and, eventually, kidney damage or failure. Early treatment is essential to prevent these complications.

Q6. What lifestyle changes can help with urinary retention?

Staying hydrated, avoiding alcohol and caffeine, and practising regular bladder training can help manage symptoms. Additionally, regular check-ups to monitor conditions like an enlarged prostate or pelvic organ prolapse are beneficial.

Q7. Are there non-surgical treatments for urinary retention?

Yes, non-surgical treatments include catheterisation, medications like alpha-blockers, and behavioural therapies. These options can help manage symptoms, especially for those with chronic urinary retention.

Q8. Can urinary retention affect my daily life?

Yes, chronic urinary retention can impact daily activities, leading to frequent bathroom visits, discomfort, and social anxiety. Proper management is crucial to maintaining quality of life.

Q9. Is urinary retention common after surgery?

Yes, postoperative urinary retention is a common temporary condition, especially after procedures involving anaesthesia or pelvic surgery. It usually resolves on its own but may require short-term catheterisation.

Q10. What happens if urinary retention is not treated?

Untreated urinary retention can lead to serious complications, including bladder damage, kidney damage, recurrent urinary tract infections, and even permanent loss of bladder function. Early intervention is critical for avoiding these outcomes.