Urinary Retention At A Glance
- Urinary retention, either acute or chronic, is the problem of being unable to empty the bladder properly.
- Urinary retention occurs most frequently in older men, but it can affect women and men of any age.
- Chronic urinary retention may cause few symptoms and sometimes people dont know they have it until urinary incontinence causes them to seek treatment.
- Acute urinary retention is a medical emergency and may involve complete inability to urinate and painful, urgent need to urinate.
- Surgical and other treatments are available to resolve urinary retention.
What Foods Are Bad For Urinary Retention
- Acidic and spicy foods: A few people complain of bladder issues with acidic and spicy foods. Acidic foods include citrus fruits and their juices, pineapple, vinegar, tomatoes and tomato products. Spicy foods include hot peppers, curry, chili sauce and powder, etc. Cuisines like Mexican, Thai and Indian are usually spicy.
- Artificial sweeteners: Some people feel discomfort and pressure in the lower abdominal area when they consume artificial sweeteners, such as Saccharin, Aspartame, and Acesulfame K.
- Constipation: Constipation may cause urinary retention. Processed foods, such as white bread, sweets, hot dogs, french fries and fast food, may cause constipation. Skipping meals may also increase the risk of constipation and one should avoid missing meals when they have urinary retention.
- Caffeinated foods and drinks: As a diuretic, caffeine may aggravate symptoms associated with urinary retention, such as urgency. Caffeine is present in a variety of different foods and beverages, including chocolate, coffee and tea. An individual may need to limit caffeine intake to avoid urinary retention.
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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How Is It Diagnosed
To diagnose urinary retention, a doctor will first ask about the history of your symptoms and perform a physical exam. The physical will include an examination of your genitals and rectum to look for any symptoms affecting those areas that may also affect the urinary tract.
Some other tests that may be used to confirm a diagnosis
likely be inserted to help quickly drain the urine. Local anesthesia will be used to make sure you dont feel pain or discomfort from the catheter.
If a catheter doesnt work or cant be used because of an injury or other condition, a doctor may insert a suprapubic catheter into the skin above your bladder to drain the urine.
Urinary Retention: Rapid Drainage Or Gradual Drainage To Avoid Complications
Background: The treatment of urinary retention is pretty straightforward place either a Foley catheter or suprapubic catheter to decompress the bladder. What is less clear, and more often debated, is if we need to clamp the catheter after 200 1000mLs of urine output or just allow complete drainage. Historic teaching has been to do intermittent volume drainage to avoid complications such as hematuria, circulatory collapse, and worsening renal failure. I distinctly remember being taught this as a resident, but not sure that I ever evaluated the literature until recently.
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Blockage In The Urethra
In order to urinate, all parts of your urinary tract need to be working properly anything that blocks the flow of urine can cause urinary retention. In men, the urethra may be blocked by an enlarged prostate, which is a common condition for older males. Blockages can also be caused by conditions such as urinary tract infections, urinary stones, and sexually transmitted diseases.
Causes Of Urinary Retention
Selected Causes of Urinary Retention
Benign prostatic hyperplasia meatal stenosis paraphimosis penile constricting bands phimosis prostate cancer
Organ prolapse pelvic mass retroverted impacted gravid uterus
Aneurysmal dilation bladder calculi bladder neoplasm fecal impaction gastrointestinal or retroperitoneal malignancy/mass urethral strictures, foreign bodies, stones, edema
Infectious and inflammatory
Balanitis prostatic abscess prostatitis
Acute vulvovaginitis vaginal lichen planus vaginal lichen sclerosis vaginal pemphigus
Bilharziasis cystitis echinococcosis Guillain-Barré syndrome herpes simplex virus Lyme disease periurethral abscess transverses myelitis tubercular cystitis urethritis varicella-zoster virus
Penile trauma, fracture, or laceration
Postpartum complication urethral sphincter dysfunction
Disruption of posterior urethra and bladder neck in pelvic trauma postoperative complication psychogenic
Selected Causes of Urinary Retention
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Initial Management Of Urinary Retention
Acute urinary retention should be managed by immediate and complete decompression of the bladder through catheterization. Standard transurethral catheters are readily available and can usually be easily inserted. If urethral catheterization is unsuccessful or contraindicated, the patient should be referred immediately to a physician trained in advanced catheterization techniques, such as placement of a firm, angulated Coude catheter or a suprapubic catheter.5 Hematuria, hypotension, and postobstructive diuresis are potential complications of rapid decompression however, there is no evidence that gradual bladder decompression will decrease these complications. Rapid and complete emptying of the bladder is therefore recommended.34
If possible, the use of chronic urethral indwelling catheters should be avoided. Complications include UTI, sepsis, trauma, stones, urethral strictures or erosions, prostatitis, and potential development of squamous cell carcinoma.44,45 In a one-year prospective study of nursing home patients, catheter use was independently associated with increased mortality.46
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What Are The Symptoms Of Urinary Retention
The signs can vary. Some people with the chronic form have a hard time starting the flow of urine. Some have a weak flow once they start. Others may feel the need to go but cant start. Others have to go a lot, while others still feel the need to go right after going. You may leak urine when you arent going because the bladder is full.
With the acute form, youre all of a sudden not able to go at all, or only able to go very small amounts. This occurs even though you have a full bladder. See a healthcare provider right away if this happens to you.
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How Common Is Urinary Retention
Urinary retention in men becomes more common with age.
- In men 40 to 83 years old, the overall incidence of urinary retention is 4.5 to 6.8 per 1,000 men.
- For men in their 70s, the overall incidence increases to 100 per 1,000 men.
- For men in their 80s, the incidence of acute urinary retention is 300 per 1,000 men.
Urinary retention in women is less common, though not rare. The incidence of urinary retention in women has not been well studied because researchers have primarily thought of urinary retention as a man’s problem related to the prostate.
- weakened bladder muscles
Obstruction of the Urethra
Obstruction of the urethra causes urinary retention by blocking the normal urine flow out of the body. Conditions such as benign prostatic hyperplasia — also called BPH — urethral stricture, urinary tract stones, cystocele, rectocele, constipation, and certain tumors and cancers can cause an obstruction.
As the prostate enlarges, the gland presses against and pinches the urethra. The bladder wall becomes thicker. Eventually, the bladder may weaken and lose the ability to empty completely, leaving some urine in the bladder.
Surgery to correct pelvic organ prolapse, such as cystocele and rectocele, and urinary incontinence can also cause urethral stricture. The urethral stricture often gets better a few weeks after surgery.
- pelvic injury or trauma
- heavy metal poisoning
Weakened Bladder Muscles
How Can I Spot The Symptoms
Acute urinary retention is extremely painful and causes abdominal bloating.
There may not be any noticeable symptoms with chronic urinary retention, but symptoms can include urinary incontinence and urinary tract infections, an increased urge to wee more frequently, difficulty getting started and producing a weak or interrupted stream of urine when weeing. There may also be mild abdominal discomfort.
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Helpful Tips For Managing Urinary Retention And Incontinence
Urinary incontinence is a prevalent issue, with anywhere from 25-50 percent of women reporting an episode in the past year.
Managing urinary conditions can be frustrating and time consuming, but there are helpful tips and lifestyle changes that can reduce the burden this condition causes.
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Symptoms Of Urine Retention
Urine retention can be uncomfortable and symptoms might include:
- Pain and bloating in the lower abdominal area.
- A frequent, urgent need to urinate but then having trouble doing it.
It’s important to be checked if you have symptoms because urine that stays in your bladder for longer than it’s supposed to could grow bacteria .
If your cancer care team thinks you might have urinary retention, they will order tests. Some of these tests include bladder ultrasound, cystoscopy, CT scans, urodynamic tests , or electromyography .
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Management Of Urinary Retention
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Acute retention of urine is usually a painful condition anyone experiencing it is likely to seek help quickly.
However, it can also be painless, and although people may be aware they have not passed urine, they may not realise that they actually have a full bladder. Patients with chronic urinary retention may not be aware there is a problem, or may attribute associated urinary symptoms such as frequency to the ageing process. Urinary retention with overflow occurs when the bladder is full and the patient passes small amounts of urine frequently .
The Initial Causes How To Naturally Reduce An Enlarged Prostate
One of the first symptoms of prostate issues is pain or tenderness in the groin or lower back. This can be the result of a noncancerous condition called enlarged prostatic tissue, or it could be an infection of the bladder. In either case, its important to see a doctor as soon as possible. If youre suffering from prostate pain, you may want to consider reducing your caffeine intake.
Another symptom of a potentially enlarged prostate is difficulty starting a stream of urine, leaking, or dribbling. These symptoms are not serious, but theyre still alarming. Most men put up with an enlarged prostate for years before seeking medical attention, but they typically seek treatment as soon as they notice symptoms. Even if you dont have symptoms, its worth getting checked to determine if you have any prostate issues.
If you experience nightly bathroom runs, you may be experiencing an enlarged prostate. You may be having difficulty starting a stream of urine, or you may even be dribbling or leaking during the day. These problems arent life-threatening, but can become a nuisance. You should not ignore these signs and seek treatment as soon as you notice them. If you feel any of these symptoms, you should consult a doctor.
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Your Urology Specialist Can Help
Having difficulty urinating is an uncomfortable and inconvenient experience. While urinary retention remedies are good practice in preventing future health concerns, not being able to urinate is a medical emergency that requires immediate attention.
Managing mild urinary retention symptoms is possible, but it is always best to see a urology specialist for a professional opinion to learn about traditional treatment options. Schedule an appointment with us, or visit your local emergency room, if you start showing symptoms of urinary retention.
This content was originally published in March 2019 and was refreshed in January 2021.
What Are The Complications Of Urinary Retention And Its Treatments
Some complications of urinary retention and its treatments may include:
- Urinary Tract Infections Because urine is normally sterile and the normal flow of urine usually prevents bacteria from infecting the urinary tract, developing urinary retention means an abnormal urine flow gives bacteria at the opening of the urethra a chance to infect the urinary tract.
- Bladder damage If your bladder is stretched too far or for extended periods, the muscles may become permanently damaged and lose their ability to properly contract.
- Kidney damage Sometime urinary retention can cause urine to flow back into the kidneys. This is called reflux and can damage or scar the kidneys.
- Urinary incontinence Transurethral surgery to treat an enlarged prostate can result in urinary incontinence in some men. Its often temporary with most men gaining bladder control in a few weeks or months after surgery. The removal of tumours or cancerous tissue in the bladder, prostate, or urethra may also result in urinary incontinence.
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Underactive Bladder Neurogenic Bladder And Urinary Retention
Underactive bladder is a condition characterized by poor bladder emptying that is not necessarily caused by BOO. It likely encompasses multiple causes and clinical conditions . This may be related to a failure of the detrusor muscles to contract and a failure of the neural pathways to properly stimulate the bladder . The ICS defines the termdetrusor underactivity as a contraction of reduced strength and/or duration, resulting in prolonged bladder emptying and/or a failure to achieve complete emptying within a normal time span .
Research on UAB is relatively new, and there are few epidemiologic studies on the condition . In a population-based survey, 23% of 633 respondents indicated they had difficulty emptying the bladder . In a similar study of older adults who had undergone urodynamic testing for voiding dysfunction, 40.2% of men and 13.3% of women were diagnosed with detrusor underactivity .Structural and functional changes appear to lead to development of underactive bladder. Ultrastructural studies have demonstrated that aging is associated with an increased deposition of collagen and a reduction in the ratio of smooth muscle to connective tissue .
Glen W. Barrisford MD, Graeme Steele MD, FCS, FACS, in, 2010
Christopher L. Wu M.D., Jeffrey M. Richman M.D., in, 2007
What The Patient Can Do
Here are some things that may help make urine retention less of a problem:
- Empty your bladder at least every 4 hours, even if you don’t feel the urge to do so.
- Empty your bowels regularly.
- If tolerated, drink 6 to 8 glasses of fluid daily, preferably water.
- Talk to your doctor about all medicines, vitamins, herbs, and supplements youre taking.
- Avoid drinks with caffeine or alcohol and citrus juices, which can irritate the bladder.
- Avoid hygiene products and chlorinated pools and hot tubs that may irritate the bladder
- Avoid smoking.
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What You Need To Know About The Prostate How To Naturally Reduce An Enlarged Prostate
The main purpose of the prostate is to produce semen, a milky fluid that sperm swims in. During puberty, the body produces semen in a large number of cases, including enlarged prostate. This fluid causes the prostate to swell and cause a number of bladder-related symptoms. This is why the prostate is important to the body. It can be caused by many factors, including infection and inflammation.
A enlarged prostate can also cause blockages in the urethra. A blocked urethra can also damage the kidneys. A patient suffering from an enlargement of the prostate may have pain in his lower abdomen and genitals. If pain is present, a digital rectal examination will reveal hard areas. A doctor may prescribe surgery or perform an endoscopic procedure. If the enlarged prostate is not completely removed, it will shrink.
While the size of an enlarged prostate will influence the extent of urinary symptoms, men may experience a range of urinary symptoms. Some men have minimal or no symptoms at all. Some men will have a very enlarged prostate, whereas others will have a mild enlargement. Generally, the symptoms can stabilize over time. Some men may have an enlarged prostate but not notice it. If they have an enlarged colon, their physician can perform a TURP procedure.