Symptoms Of Urinary Retention
Acute urinary retention requires immediate medical attention. Symptoms include:
- A complete inability to pass urine
- A painful urge to urinate
- Pain or swelling in your lower abdomen
Chronic urinary retention symptoms include:
- Frequent urination
- Trouble starting urination
- Weak or intermittent urination stream
- A feeling of needing to urinate after finishing urination
How Is Chronic Urinary Retention Diagnosed
History and physical exam: During the diagnosis process, your healthcare provider will ask about your signs and symptoms and how long you have had them. He or she will also ask about your medical history and your drug use. A physical exam of the lower abdomen may show the cause or give your provider additional clues. After this, certain tests may be needed. Men may have a rectal exam to check the size of their prostate.
Your urine may be saved and checked to look for infection.
Ultrasound of the bladder: The amount of urine that stays in your bladder after urinating may be measured by doing an ultrasound test of the bladder. This test is called a postvoid residual or bladder scan.
Cystoscopy: Cystoscopy is a test in which a thin tube with a tiny camera on one end is put into your urethra. This lets the doctor look at pictures of the lining of your urethra and bladder. This test may show a stricture of the urethra, blockage caused by a stone, an enlarged prostate or a tumor. It can also be used to remove stones, if found. A computed tomography scan may also help find stones or anything else blocking the flow of urine.
Urodynamic testing: Tests that use a catheter to record pressure within the bladder may be done to tell how well the bladder empties. The rate at which urine flows can also be measured by such tests. This is called urodynamic testing.
When To Seek Medical Care
A person who has any of the following symptoms should see a health care provider right away:
- complete inability to urinate
- electromyography
Physical Exam
A health care provider may suspect urinary retention because of a patient’s symptoms and, therefore, perform a physical exam of the lower abdomen. The health care provider may be able to feel a distended bladder by lightly tapping on the lower belly.
Postvoid Residual Measurement
This test measures the amount of urine left in the bladder after urination. The remaining urine is called the postvoid residual. A specially trained technician performs an ultrasound, which uses harmless sound waves to create a picture of the bladder, to measure the postvoid residual. The technician performs the bladder ultrasound in a health care provider’s office, a radiology center, or a hospital, and a radiologist — a doctor who specializes in medical imaging — interprets the images. The patient does not need anesthesia.
A health care provider may use a catheter — a thin, flexible tube — to measure postvoid residual. The health care provider inserts the catheter through the urethra into the bladder, a procedure called catheterization, to drain and measure the amount of remaining urine. A postvoid residual of 100 mL or more indicates the bladder does not empty completely. A health care provider performs this test during an office visit. The patient often receives local anesthesia.
Medical Tests
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Surgical Treatment Is Necessary For Some Cases These Treatments Might Include:
- Prostate surgery. The most common surgery is transurethral resection of the prostate. In this procedure, the urologist uses a tiny tool, inserted through a catheter, to remove a section of the prostate. This treatment is used frequently for urinary retention caused by BPH.
- Internal urethrotomy. When there is a stricture that cannot be resolved by widening, a urologist can open the stricture with an incision. The procedure is performed via a special catheter inserted into the urethra.
- Cystocele or rectocele repair. Women whose bladder or rectum has fallen may need surgery to return the organs to their normal position. A urologist specializing in female reproductive surgery will repair any defects in the tissue of the vaginal wall. This repaired tissue then will be strong enough to hold the organs in their proper places, restoring normal urinary retention function.
- Removal of tumors or cancer. If the cause of the urinary retention is a tumor or cancerous tissue in the urethra, bladder or prostate, removing those tissues may reduce the problem.
Urine Retention Home Remedies That Really Work
Urinary retention can be related to some form of obstruction, but it can also be the result of other causes that are not related any form of obstruction. In the case of an obstruction, there is often little you can do to correct the situation apart from the removal of the obstruction, but there are urine retention home remedies to help non-obstructed cases and to prevent the development of obstructions.
Please keep in mind that although the home remedies can help relieve urine retention, they are not all-inclusive cures and avoiding the advice and treatment of a health care professional can be fatal.
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How Can Urinary Retention Be Prevented
For men:
If you have an enlarged prostate, be sure to take prostate medications as prescribed by your doctor and avoid medications associated with urinary retention, such as over-the-counter cold and allergy medications that contain decongestants.
For women:
If you have mild cystocele or rectocele, you may be able to prevent urinary retention by doing exercises to strengthen the pelvic muscles.
Kimberly-Clark Australia makes no warranties or representations regarding the completeness or accuracy of the information. This information should be used only as a guide and should not be relied upon as a substitute for professional medical or other health professional advice.
Healthdirect.gov.au, . Urinary retention. Available at: .
http://www.health.qld.gov.au, . Adult Urinary Obstruction, Retention and Bladder Scanning. Available at: .
John P. Cunha, F. . Urinary Retention: Get the Facts on Causes and Treatment. MedicineNet. Available at: .
Kidney.niddk.nih.gov, . Urinary Retention – National Kidney and Urologic Diseases Information Clearinghouse. Available at: .
Knott, MD, L. . Acute Urinary Retention. Information about AUR. Patient | Patient.co.uk. Patient.co.uk. Available at: .
Nerve Disease Or Spinal Cord Injury
Many events or conditions can damage nerves and nerve pathways. Some of the most common causes are
- vaginal childbirth
- infections of the brain or spinal cord
- accidents that injure the brain or spinal cord
- multiple sclerosis
- heavy metal poisoning
- pelvic injury or trauma
In addition, some children are born with nerve problems that can keep the bladder from releasing urine.
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Blockage Or Narrowing Of The Urethra Or Bladder Neck
In order for you to urinate normally, all parts of the urinary tract must work together in the correct order. Urine normally flows from the kidneys to the bladder through the ureters and out through the urethra. If a blockage or narrowing occurs somewhere along the urinary tract, the person may have difficulty urinating and, if the blockage is severe, may not be able to urinate at all.
Medical problems that could narrow the urethra and block the flow of urine include:
- serotonin and norepinephrine reuptake inhibitors
- nonsteroidal anti-inflammatory drugs such as aspirin and ibuprofen
- Parkinsons medications
Surgery. It is common to develop temporary urinary retention immediately after surgery. During surgery, the patient is often given fluid through a vein , which can cause a full bladder. You are also given anesthesia , which can keep you from feeling the need to urinate despite a full bladder. Additionally, pelvic surgery can cause inflammation, scar tissue, and trauma that can partially or completely block the flow of urine out of the bladder or urethra.
Weak bladder muscles. Weak bladder muscles may not contract with enough power or force to empty the bladder completely. Causes of weakness can include:
- pregnancy and childbirth
- age-related loss of bladder muscle power
- overdistention or a bladder that has been stretched in such a way that the muscles are injured
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Why Do Hormones Cause Water Retention
Estrogen and progesterone can affect your fluid balance and lead to increased water weight. Studies suggest that these hormones change your bodys regular set points for water and sodium movement. Most of the time, the excess water weight improves after your period starts, and things return to normal .
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How Is Urinary Retention Treated
Treatment for urinary retention can depend on whether you have the acute form or the chronic form, as well as the cause of the condition. For the acute form, a catheter is put into the urethra to drain the bladder.
Treatment of the chronic form or the acute form that becomes chronicwill depend on the cause.
Medications for enlarged prostate: For men with an enlarged prostate, certain drugs may be used to try and open it up or shrink it. These include alpha-blockers and 5-alpha reductase inhibitors . Also, procedures or surgery to open up the prostate may be tried.
Procedures for enlarged prostate: Many procedures are available when this problem is due to an enlarged prostate. Office-based treatments can be done with just local anesthetic only. These include water vapor therapy and prostatic urethral lift .
There are also several surgeries done under general anesthesia which are available. These include shaving down the inside of the prostate and opening up the prostate with a laser . A laser can also be used to carve out the entire enlarged portion of the prostate through the urethra , or this part of the prostate can be removed through the belly . All of these procedures can be effective in opening up the blockage.
Treatment for nerve issues: If the retention is due to a nerve-related issue, you may need to use a catheter on yourself at home.
What Are The Possible Complications Of Urinary Retention
The complications of urinary retention and its treatments may include:
UTIs: the normal flow of urine usually prevents germs from infecting the urine. With urinary retention, bacteria may be able to infect the urine because the urine cannot flow out of the bladder.
Bladder damage: if the bladder becomes stretched too far or for long periods, the muscles may become damaged and unable to work properly.
Chronic kidney disease: for some people, urinary retention causes urine to flow backwards into the kidneys. This backward flow is called reflux and it may damage or scar the kidneys.
Urinary incontinence: this may occur together with chronic urinary retention or after surgery .
Prostate gland surgery may cause urinary incontinence in some men. This problem is often temporary and gets better quite quickly. Most men recover their bladder control in a few weeks or months after surgery.
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What Is The Urinary Tract
The urinary tract consists of the organs, tubes, and muscles that work together to make, move, store, and release urine. The upper urinary tract includes the kidneys, which filter wastes and extra fluid from the blood, and the ureters, which carry urine from the kidneys to the bladder. The lower urinary tract includes the bladder, a balloon-shaped muscle that stores urine, and the urethra, a tube that carries urine from the bladder to the outside of the body during urination. If the urinary system is healthy, the bladder can hold up to 16 ounces-2 cups-of urine comfortably for 2 to 5 hours.
Muscles called sphincters squeeze shut the tubes from the bladder to help keep urine from leaking. The sphincter muscles close tightly like a rubber band around the opening of the bladder, which leads into the urethra.
Nerves in the bladder tell you when it is time to urinate. As the bladder first fills with urine, you may notice afeeling that you need to go. The sensation to urinate becomes stronger as the bladder continues to fill. As itreaches its limit, nerves from the bladder send a message to the brain that the bladder is full and the urge toempty your bladder intensifies.
When you urinate, the brain signals the bladder muscle to tighten, squeezing urine out of the bladder. At the sametime, the brain signals the sphincter muscles to relax. As these muscles relax, urine exits the bladder through theurethra. When all the signals occur in the correct order, normal urination occurs.
Urinary Retention: Does Drinking Water Really Help
Urinary retention is a condition characterized by an inability to fully empty the bladder. The bladder serves as a storage tank for urine, a substance made by the kidneys after they have filtered out waste and extra water from your blood. Once made, the urine travels to the bladder where it will stay until a person is ready to urinate. In a healthy individual, the bladder can hold up to two cups of urine comfortably for up to five hours.
Urinary retention can occur for a variety of reasons. Among men, an enlarged prostate is the most common cause. Among women, bladder muscle dysfunction and urinary stones are the typical culprits. Individuals with this condition may experience:
- Difficulty starting the flow of urine
- A weak urine flow
- Feeling the need to urinate right after using the bathroom
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Treatment Of Specific Symptoms
Depression and emotional lability are common symptoms of MS. In addition to appropriate supportive care and counseling, antidepressant therapy with one of the activating serotonergic or noradrenergic drugs can be of benefit for depression as well as for anxiety and panic symptoms Most patients do not seem to tolerate paroxetine well long term fluoxetine and sertraline work for panic and anxiety. Patients with pain or insomnia may benefit more from a sedating antidepressant given at bedtime, which may have the added anticholinergic benefits on urinary bladder urgency.
Spasticity can be managed by physical therapy, stretching, and institution of either baclofen or tizanidine . Either drug should be started as a single agent at a low dose at bedtime, gradually increasing to three to four times daily, with a larger dose at bedtime to target nocturnal symptoms. Decreasing muscle tone can result in weakness. Baclofen should never be discontinued abruptly because of the potential for a severe withdrawal reaction.
Painful dysesthesias and paroxysmal dystonic spasms may be managed effectively with antiepileptic drugs or tricyclic antidepressants . Patients with trigeminal neuralgia may respond to these drugs or to baclofen, misoprostol, botulinum toxin, or decompression surgery consideration of intravenous loading with an antiepileptic drug is worthwhile for severe acute pain attacks.
Urinary Retention Treatment Prevention And Home Remedies
Urinary retention treatment is designed to rectify the problem of being unable to completely empty the bladder. Occurring more commonly in older men, urinary retention can be a serious condition that may lead to emergency urinary retention treatment.
Acute urinary retention happens suddenly and lasts only a short time. Chronic urinary retention, on the other hand, can be long-lasting and is likely caused by a medical condition. Acute variants can be potentially life-threatening, causing great discomfort or pain and requiring immediate medical treatment. Chronic variants of the condition permit a small amount of urine output, leading sufferers to feel they have not completely emptied their bladders.
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Why Can An Enlarged Prostate Cause Urinary Retention
This symptom occurs because of the prostates location. It not only sits underneath the bladder but it surrounds the urethra. As it expands, it is largely prevented from expanding outwards because of the tissues around it. Instead it grows inwards, squeezing the urethra. This makes it more difficult for urine to pass from the bladder through the urethra.
In severe cases, the prostate can completely block off the urethra, meaning that no urine can leave the bladder at all: this is when acute urinary retention occurs.
When To See A Doctor
Seek emergency care immediately if youre unable to urinate or youre experiencing severe pain in your lower abdomen. These are symptoms of acute urinary retention, which is very serious and can be life-threatening if its not treated as soon as possible. If youre experiencing any other urinary retention symptoms, it is still important to talk with your healthcare professional, as chronic urinary retention can also cause serious health problems if left untreated.
To treat acute urinary retention, your urologist will drain the bladder by placing a catheter into your urethra. Removing the urine from your bladder will provide immediate relief and help prevent your bladder and kidneys from being damaged.
For chronic urinary retention, your urologist will assess your symptoms and suggest treatments depending on what is causing your urinary retention. Some treatments that a doctor might recommend include antibiotics for a urinary tract infection, physical therapy for pelvic floor dysfunction, or a surgical procedure to treat a blocked urethra or an enlarged prostate.
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Causes Of Urinary Retention
There are many different causes.
Blockage In men, the urethra may be constricted by an enlarged prostate a common condition for men over 50. In women, blockage can be caused by certain types of pelvic prolapse, including Cystocele and Rectocele .
Other blockage reasons for both men and women include urethral stricture and urinary stones.
Infection / Swelling In men, prostatitis , can cause swelling that blocks the free flow of urine. Urinary Tract Infections and Sexually Transmitted Diseases can also cause swelling that leads to urinary retention.
Nerve Problems Urinary retention could be caused by a problem with the nerves that control the bladder. If the nerves are damaged, it can cause a breakdown in the signals between the brain and bladder. Some causes of nerve damage include:
What Causes Urinary Retention
Urinary retention can be attributed to two causes either obstruction or non-obstruction.
If there is an obstruction , a blockage occurs and urine cannot flow unimpeded through your urinary track. This is the basis for acute urinary retention and is potentially life threatening. You must seek immediate emergency treatment.
Non-obstructive causes include a weakened bladder muscle and nerve problems that interfere with signals between your brain and the bladder. If the nerves arent working properly, your brain may not get the message that the bladder is full.
Obstructive urinary retention causes include:
- Enlarged prostate in men
- Nerve disease in both men and women
- Impaired muscle or nerve function due to medication or anaesthesia
- Accidents that injure the brain or spinal cord
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