Obstruction In People With A Penis
Possible causes of obstruction in people with a penis
- Cystocele. Cystocele occurs when the bladder lowers and pushes against your vagina.
- Rectocele. This is when the rectum expands and pushes against your vagina.
- Uterineprolapse. Uterine prolapse occurs when the uterus lowers and pushes against the bladder.
How Bothersome Is It
Doctors use the International Prostate Symptom Score to measure how frequent a man’s symptoms are. It’s a seven-item questionnaire about typical BPH symptoms that provides a score from 0 to 35. You can see the questionnaire at health.harvard.edu/IPSS.
Typically, men who score 8 and above are more likely to think their condition needs treatment, but it varies from man to man. “Above a score of 8 there is actually a spectrum of bother,” Dr. Barry says. “Two men can have the same symptom score, and one can tolerate it just fine but the other can’t.”
The IPSS test cuts through the subjectivity with this additional question: “If you were to spend the rest of your life with your urinary condition just the way it is now, how would you feel about that?” If the answer is, “I could live with it,” then watchful waiting might be best for you.
But watchful waiting doesn’t mean “do nothing.” It should include strategies to lessen symptoms or make them easier to cope with. In one recent study, men who attended classes on such self-management techniques lowered their IPSS symptom scores by 6 points within three months. “Six points is a difference most men would perceive,” Dr. Barry says.
Drinking Water & Other Home Remedies For Urinary Retention
Urinary retention is often treated by addressing the underlying condition. For example, prostate medication can help to shrink an enlarged prostate so its no longer pressing on the urethra, which can improve urine flow. Pelvic floor physical therapy may be helpful for women with cystoceles to strengthen the pelvic floor muscles and reduce urinary retention symptoms.
There are also a variety of natural remedies that can address slow urine flow, the most common one being hydration. It makes sense to think that drinking less water can ease symptoms , but thats actually not true. Water is essential to the function of the body and without it, blood vessels cant deliver important nutrients to the kidneys. In turn, the kidneys will only be able to make highly concentrated urine that irritates the bladder. Therefore, staying hydrated by drinking plenty of water throughout the day is one of the essential pieces of any treatment plan for urinary retention.
How much water you need per day depends on several factors, including where you live, your activity level, and your age. In general, the long-standing advice of drinking 8 cups of water per day is a good guideline to follow. And remember, liquids other than water can count towards that total, such as tea, coffee, sports drinks, and fruit juice. As long as you arent feeling thirsty on a regular basis and your urine is colorless or light yellow, youre likely drinking enough water for your needs.
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When To See A Doctor
Anyone experiencing symptoms of acute urinary retention should go to the emergency room.Chronic urinary retention is not a medical emergency, but it does usually indicate a potentially serious underlying problem.
A person should schedule an appointment with a doctor for urinary retention that lasts longer than a few days or that goes away and then returns.
People who experience temporary urinary retention due to medication or anesthesia may not need medical treatment if the symptoms disappear and do not return.
Although anyone can develop urinary retention, it is more common as a person ages. Males are also more likely than females to have urinary retention due to prostate issues and partial blockages of the urethra.
Some other risk factors include:
What Specialists Treat Urinary Retention
Urologists are most often involved in the care of patients with urinary retention. However, urogynecologists also treat women with urinary retention. Internists, family physicians, and emergency-room physicians also frequently treat urinary retention and will refer you to a urologist or urogynecologist if it is not improving.
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What Foods Are Bad For Urinary Retention
Urinary retention is a condition in which you cannot empty your bladder completely. While no direct connection exists between diet and urinary retention, certain foods may aggravate 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.
Data Abstraction And Data Management
We will review bibliographic database search results for studies relevant to our PICOTS framework and study-specific criteria. The use of previous systematic reviews to replace the de novo process will be explored when relevant or partially relevant systematic reviews are identified and judged to be of fair or good quality by using modified AMSTAR criteria.9 Search dates may be altered in the presence of high-quality systematic reviews for specific populations and/or interventions.
Review of bibliographic database searches will occur in two stages. First, titles and abstracts will be reviewed by two independent investigators to identify studies meeting the criteria in the PICOTS framework and study-specific criteria. At this stage we plan to include all interventions identified in the literature. At completion of this stage, we will consult with our Technical Expert Panel to ensure that we capture only studies examining relevant interventions . All studies identified as relevant by either investigator will undergo full-text screening. Two independent investigators will screen the full text to determine if our inclusion criteria are met. Differences in screening decisions will be resolved by consultation between investigators and a third investigator if necessary. We will document the inclusion and exclusion status of citations undergoing full-text screening.
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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
- Certain tumours and cancers
- 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
Treating And Preventing Urinary Retention
Treatment will differ depending on the severity of the condition. The following are potential treatments:
Bladder drainage: Involves inserting a tube called a catheter up through the urethra and into the bladder for drainage. Those suffering from acute cases of urinary retention will see immediate relief of their distressful symptoms. This procedure can be done in an office or in a hospital setting, with the patient receiving local anesthesia. In the rare case that the urethra is blocked not allowing a catheter to travel upward the doctor can pass the tube directly through the lower abdomen into the bladder. People with chronic cases of urinary retention may require intermittent, occasional, or long-term catheterization if other treatments do not work.
Urethral dilation: A treatment for urethral strictures a cause of urinary retention that works by inserting increasingly wider tubes into the urethra to widen the stricture. A stricture, by definition, is an abnormal narrowing of a passage that may be due to scar tissue. Local anesthesia is always utilized, and if necessary, the patient will receive sedation and regional anesthesia.
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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.
What Is Acute Urinary Retention
As we mentioned, urinary retention is when your bladder doesnt fully empty while using the restroom, even if its still full. Although you will still feel the need to urinate, you cant empty your bladder. Urinary retention comes in two forms, acute and chronic.
Acute urinary retention is when it happens suddenly. Youre unable to urinate, even though your bladder is completely full. Acute urinary retention often only lasts a short time, but it can cause severe pain and even be life threatening.1 Due to the severity of acute urinary retention, its considered a urologic emergency and requires immediate medical care. The primary symptom that youll experience with AUR is a feeling like you need to use the bathroom but cant accompanied by high levels of pain or discomfort in your lower abdomen.2
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What Causes Chronic Urinary Retention
Urinary retention can happen for several different reasons. These causes can include:
- A blockage to the way urine leaves your body.
- Medications youre taking for other conditions.
- Nerve issues that interrupt the way your brain and urinary system communicate.
- Infections and swelling that prevent urine from leaving your body.
- Complications and side effects of medications given to you for a surgical procedure.
Blockage
When something blocks the free flow of urine through the bladder and urethra, you might experience urinary retention. The urethra is the tube that carries urine from the bladder to the outside of your body. In men, a blockage can be caused when the prostate gland gets so big that it presses on the urethra. This is the most common cause of chronic urinary retention in men. One cause in women is a bladder that sags. This is called cystocele. It can also be caused when the rectum sags into the back wall of the vagina a condition called rectocele. Some causes can happen to both men and women. The urethra can get narrow due to scar tissue. This is called a stricture. Urinary stones can also block the flow of urine out of your body.
Medications
Nerve issues
- Trauma to the spine or pelvis.
- Pressure on the spinal cord from tumors and a herniated disk.
- Vaginal childbirth.
Urinary retention from nerve disease occurs at the same rate in men and women.
Infections and swelling
Surgery
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
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What Is An Inability To Urinate
Urinary retention is the inability to completely empty your bladder. Urinary retention may be sudden in onset or gradual in onset and chronic . When you cannot empty your bladder completely, or at all, despite an urge to urinate, you have urinary retention. To understand how urinary retention occurs, it is important to understand the basics of how urine is stored in and released from the body.
The bladder is a hollow balloon-like organ in the lower part of the belly that stores and eliminates urine.
Urinary retention may cause harm to the function of the bladder and the kidneys, incontinence, and may increase the risk of urinary tract infections. Thus, it requires urgent medical attention for evaluation and management. In some cases, hospitalization is required.
Urinary retention is not an unusual medical condition, and it is more common in men than in women.
Common Causes Of Urinary Retention
Examples of some of the most common causes of non-obstructive urinary retention are:
A pelvic fracture is a break that affects the structure of the pelvis, which can include the hip bones, sacrum, or coccyx, and be extremely painful. If complications occur, it may lead to internal bleeding or an injury to the bladder.
Certain medications, such as antihistamines, and antispasmodic drugs which aid digestion, can cause urinary retention. They decrease bladder muscle contraction, preventing the bladder from being completely emptied.
Antidepressant meds have anticholinergic properties at therapeutic doses that contribute to urinary problems.
The side effects of anesthetics after surgery can impair muscle or nerve function of the bladder. The pain-relieving drugs often have a disruptive impact on the neural messaging to the part of the brain, which controls the nerves and the muscles in the urinary process.
Accidents that injure the brain or the spinal cord can also impact negatively on the neurological process of the urinary system.
Fortunately, no matter what type of urinary retention you may have, there is treatment available.
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When Should Someone Seek Medical Care For An Inability To Urinate
- This condition requires urgent bladder drainage to prevent damage to the bladder, kidneys, and ureter.
- Your doctor may advise you to go to a hospital emergency department without delay.
- If you have symptoms of chronic urinary retention, you should also let your health care provider know, since chronic urinary retention may lead to urinary tract infections, incontinence, further bladder damage, and damage to your kidneys.
Urologists are most often involved in the care of patients with urinary retention. However, women are also often treated by urogynecologists. Internists, family physicians, and emergency-room physicians also frequently treat urinary retention.
What Are The Complications Of Urinary Retention And Its Treatments
- urinary incontinence after prostate, tumor, or cancer surgery
UTIs. Urine is normally sterile, and the normal flow of urine usually prevents bacteria from infecting the urinary tract. With urinary retention, the abnormal urine flow gives bacteria at the opening of the urethra a chance to infect the urinary tract.
Bladder damage. If the bladder becomes stretched too far or for long periods, the muscles may be permanently damaged and lose their ability to contract.
Kidney damage. In some people, urinary retention causes urine to flow backward into the kidneys. This backward flow, called reflux, may damage or scar the kidneys.
Urinary incontinence after prostate, tumor, or cancer surgery. Transurethral surgery to treat benign prostatic hyperplasia may result in urinary incontinence in some men. This problem is often temporary. Most men recover their bladder control in a few weeks or months after surgery. Surgery to remove tumors or cancerous tissue in the bladder, prostate, or urethra may also result in urinary incontinence.
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Should I Be Worried About Urinary Retention
Urinary retention affects people of all ages and occurs in both sexes. However, it is most common in older men who have an enlarged prostate gland. It develops slowly over time. You may not notice it until you are unable to urinate. This causes swelling and discomfort in your bladder. It is a condition that is diagnosed in millions of adults due to various causes, but it doesnt have to control your life. If youre struggling from one or more of the symptoms of urinary retention, you may need to visit a urologist. Diagnosis is important in case of urinary retention as treatment starts with identifying an underlying medical cause.
Diagnosis Of Urinary Retention
When a person seeks treatment for urinary retention, the doctor will do a physical exam and ask about symptoms and medications.
For men, the doctor may do a rectal exam to check the size of the prostate, a walnut-sized gland located between the bladder and the penis. An enlarged prostate might press the urethra and cause urinary retention. Doctors might order blood tests to screen for prostate cancer, which is very common among older men.
The doctor also may order tests including:
- Urinalysis to check for infection or blood in urine.
- Ultrasound to see how much urine remains in the bladder after voiding.
- Cystoscopy, a test where a tiny camera is inserted through the urethra, allowing the doctor to see the inside of the urethra and bladder.
- CT scan, which looks for stones or other blockages of the urine flow.
- Urodynamic tests of urine flow.
- Electromyography , which measures how well the muscles and nerves work around the bladder and the urethra.
In some cases, doctors also might order an MRI test of the pelvic region and/or the brain to determine the cause of the urinary retention.
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