WHAT CAUSES URINARY RETENTION AND HOW IS IT TREATED?

Urinary retention is a condition in which your bladder doesn’t empty completely even if it’s full and you often feel like you really have to urinate. There are two forms of urinary retention — acute and chronic.

 

What are the symptoms?
 

Acute
 

Acute urinary retention happens suddenly and can become life-threatening. You feel like you need to urinate badly, but you can’t go at all. This causes a lot of pain and discomfort in your lower abdomen. Get emergency medical care right away to release the buildup of urine.

 

Chronic
 

Chronic urinary retention occurs over a long period of time. You can urinate, but your bladder doesn’t empty completely. You may not even know you have this condition because you have no symptoms at first.

 

 

You feel like you have to urinate frequently, often eight or more times a day.
 

 

 

Your lower urinary tract is made up of your bladder, which stores urine, and your urethra, which is a tube between your bladder and the outside of your body. In men, the prostate is also part of this system. There are two sets of muscles called sphincters. The internal sphincter is where your urethra connects to your bladder (the bladder outlet). The external sphincter, further down the urethra, opens and closes to control when urine can leave the bladder. In men, the prostate surrounds the urethra along its course through the pelvis between these two sphincters.
 

When you urinate, the muscles in your bladder squeeze to push urine out. At the same time, your nervous system tells the sphincters to open and the urine passes through your urethra and out of your body. The two sphincters are made up of different muscle types, so you can’t control the internal sphincter but you can control the external one. A problem in any of these structures or the nerves that make them work can cause urinary retention.

 

How it’s treated
 

Acute
 

Acute urinary retention is a medical emergency, and your doctor will quickly place a catheter into your bladder to let out the urine. This is the quickest and easiest procedure.

 

Chronic
 

Chronic urinary retention is treated if you develop symptoms that affect your quality of life or if you are experiencing urinary tract complications.

 

Catheterization
 

You’ll probably need catheterization to release the urine from your bladder unless the cause of your urinary retention can be fixed right away.

 

Urethral dilation and stents
 

This procedure can be used to widen a urethral stricture in order to allow more urine to flow through. Tubes of increasing width are inserted into your urethra. This slowly opens the stricture. Another way to do this is to insert a tube with a balloon into your urethra and inflate the balloon in the stricture.

 

Cystoscope
 

A lighted, flexible tubular scope called a cystoscope can be inserted through your urethra into your bladder. There, it can be used to find and remove stones or foreign objects from your bladder, bladder outlet, or urethra.

 

Medication
 

There are several medications that your doctor might prescribe to help your urinary retention:

 

Behavior modification
 

There are some things you can do to learn to control your bladder or make it less likely that you’ll retain urine:

 

 

Surgery
 

If medication and other therapies haven’t worked to relieve symptoms, surgery may be an option. In men, most surgical procedures are done by inserting an instrument through the urethra. The surgeon then uses an attached tool or laser to fix the problem. 

 

Both acute and chronic urinary retention are often easy to diagnose. They are both accompanied by an inability to urinate effectively. They can usually be treated by a combination of options in order to avoid long-term complications. If the problem can’t be permanently fixed with surgery or other treatment, you may need to use a catheter on your own intermittently. You’ll get used to this and it won’t limit your daily activities or quality of life.