Causes Of Problems Storing Your Urine
In MS, problems storing urine happen because messages are interrupted between the bladder emptying reflex in your spinal cord and the part of your brain that has control over when you empty your bladder. This can result in the reflexes telling the bladder muscle to contract as soon as it starts filling. The bladder can become overactive and spasm or tighten unpredictably, resulting in an immediate or frequent urge to go. This is also known as overactive bladder.
I feel as though my bladder has a life of its own.
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 Bothersome Is It
Doctors use the International Prostate Symptom Score to measure how frequent a mans symptoms are. Its 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 cant.
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 doesnt 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.
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Complications Of Urinary Retention
Frequent urinary tract infections resulting from bacteria if the urine stays in the bladder.
Long term obstruction of the urinary tract may lead to painful bladder stones.
Serious bladder damage, such as losing the ability to contract if it becomes stretched for a lengthy period of time.
If urine backs up into the kidneys, it can lead to congestion, reducing kidney function. It can also leave you with a high risk of falling prey to chronic kidney disease.
Urinary retention may also promote the formation of small pouches in the bladder wall, similar to those in the bowel which can trap bladder stones, causing pain and discomfort. Bacteria present in the pouches can multiply and are liable to cause infections.
The Main Causes Of Urinary Retention In Women
Your bladder and your urethra make up your lower urinary tract. Your bladder stores urine and your urethra is a tube that connects your bladder to the outside of your body. The prostate is an additional part of this system for men.
When its time to urinate, the muscles that are in your bladder squeeze in order to push urine out of your body. Simultaneously, your nervous system is communicating to your sphincters that they should open. When all is going well, the urine will then travel through your urethra and leave your body.
You have two different sphincters, an internal sphincter and an external sphincter. While you do have control over the external sphincter, you cant control the internal sphincter.
If there are issues with any of these structures it can lead to urinary retention. Additionally, if there are problems with the nerves that make them work it can also lead to this disorder.
Click here for a more thorough look at the urinary system and how it works.
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What Are Risk Factors And Causes Of An Inability To Urinate
There are a number of medical conditions and medications that may cause urinary retention. These medical conditions and medications may affect the function of the bladder itself, the function of the outlet of the bladder, and/or the urethra. Obstruction may be fixed or dynamic . There are also infectious causes and surgical causes of urinary retention.
Common Causes/Risk Factors
Certain medications can cause urinary retention, especially in men with prostate enlargement. Many of these medications are found in over-the-counter cold and allergy preparations. These drugs include the following:
- Drugs that act to tighten the urinary channel and block the flow of urine include ephedrine , pseudoephedrine , phenylpropanolamine , phenyleprhine , and amphetamines.
- Antihistamines such as diphenhydramine and chlorpheniramine , as well as some older antidepressants, can relax the bladder too much and cause urination problems.
- Beta-adrenergic sympathomimetics, including isoproterenol , terbutaline , and metaproterenol
- Opioid-containing medications
Urinary Retention in Children
Problems With The Nerves Supplying The Bladder
Urinary retention can result from problems with the nerves that control the bladder and the valves that control the flow of urine from the bladder.
Even when the bladder is full, the bladder muscles that squeeze urine out may not receive the signal to push. The sphincters may not receive the signal to relax and allow the bladder to empty. Possible causes of nerve problems that may cause urinary retention include diabetes, a stroke, multiple sclerosis or after an injury to the pelvis.
Some children are born with conditions that may affect the nerve signals to the bladder. For example spina bifida may cause urinary retention in newborn babies.
Deterrence And Patient Education
Urinary retention is the inability to pass urine and can be acute or chronic. Although uncommon in women when compared to men, sill this can lead to significant issues like not urinating at all when the problem is not recognized early. Patients should speak with their doctors if they have any issues urinating, dribbling of urine intermittently, foul smell of urine. Patients should also be aware of medications that can cause urinary retention.
What Are The Signs And Symptoms Of Urinary Retention
- Frequent urination, or the urge to urinate right after you finish
- An urge to urinate, but your urine does not come out or dribbles out slowly and weakly
- Frequent urine leaks that happen during the day or while you sleep
- Pain or pressure when you urinate
- Pain or stiffness in your abdomen, lower back, hips, or upper thighs
- Blood in your urine
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How Are Bladder Problems Treated
When you see your health professional they will take a full history of your symptoms and they might ask you to keep a detailed bladder diary for a short period of time. As different types of bladder problems are treated differently, health professionals need to find out the cause of your bladder problems so they can find the most appropriate treatment options for you. This will usually involve the following investigations.
- Urine test Your health professional may ask for a sample of your urine so they can test it for any infection this is sometimes called a dipstick test. Your urine will be test for bacteria using a small, chemically treated stick that is dipped into your urine sample. If bacteria are present it will change colour, indicating you may have a urinary tract infection .
- Bladder ultrasound If there is no sign of a urinary tract infection, the amount of urine left in your bladder after urinating will be measured. This is carried out with a simple ultrasound scanner which is gently applied to your lower abdomen and moved over the skin. This creates an image of your bladder and shows how much fluid is left inside. If there is less than 100ml left after your bladder has been emptied, then symptoms are more likely to be due to problems storing urine. If more than 100ml remains after emptying, then the symptoms are likely to be due to problems with emptying the bladder.
Utis And Ms: How To Prevent This All
Why are people who have MS prone to UTIs? And how can you prevent more of them? Find the answers here.
Canva Everyday Health
At least 80 percent of people who have multiple sclerosis have some bladder dysfunction, which can lead to frequent bladder or urinary tract infections , according to the National Multiple Sclerosis Society .
Its common for people who have MS to have difficulties fully emptying their bladder, which puts them at increased risk of UTIs, notes the NMSS. Urine that stays the bladder too long breeds an abundance of bacteria, which eventually leads to infection. Holding urine also allows mineral deposits to form stones that can lead to infection and irritate bladder tissues.
Talking to your doctor about any bladder dysfunction issues you may have can help stave off repeated UTIs, which can be serious in some cases for people who have MS. Taking steps to prevent UTIs, and seeking prompt diagnosis and treatment when youre having symptoms, can also be helpful.
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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.
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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Treatment Of Urinary Retention
Many treatments are available for urinary retention, including medication, devices, procedures and surgery. Treatment will depend on the cause and the disease specifics.
For acute urinary retention, medical providers will use a catheter to drain the bladder. Then the doctor will seek the cause of the urinary retention and determine a course of treatment.
What Are The Complications Of Urinary Retention And Its Treatments
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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What Is The Long
The degree of success after rectocele repair depends on a number of factors, including:
- Type of symptoms present.
- Length of time the symptoms have been present.
- Surgical method and approach taken.
Studies show about 75% to 90% of patients have significant improvement but this level of satisfaction decreases over time.
How Can Urinary Retention Be Prevented
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.
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: .
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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.
Planned Times For Drinking And Urinating
Drink water at designated times during the day, and plan bathroom breaks afterward.
Bladder training can be helpful, too. This technique involves keeping a journal and scheduling times to urinate, whether or not you feel the urge, says Epstein.
Double voiding is another technique that can help, the Urology Care Foundation says. To double void, urinate, wait a few minutes, then try to urinate again.
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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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Change Your Bathroom Habits
Use the bathroom whenever you have an urge to go. Often, people hold their urine because its not a good time to go to the bathroom. However, regularly holding urine in can wear out your bladder muscles. Youre also more likely to develop a urinary tract infection if you hold urine in. UTIs can cause urinary retention.
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Prevalence Of Luts In Ms
LUTS are common in MS patients. Based on the North American Research Committee on Multiple Sclerosis Registry, a large survey of more than 9700 MS patients, 65% reported moderate to severe urinary complaints. Nocturia, followed by urinary urgency and frequency were the most prevalent signs. Urinary incontinence and poor bladder emptying were noted less frequently. summarizes the data on and prevalence of LUTS in these patients.
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
For hospitalized patients requiring catheterization for 14 days or less, a Cochrane review found that silver alloy-impregnated urethral catheters have been associated with decreased rates of UTI versus standard catheters.41 Another Cochrane review concluded that patients requiring catheterization for up to 14 days had less discomfort, bacteriuria, and need for recatheterization when suprapubic catheters were used compared with urethral catheters.42 In a recent meta-analysis of abdominal surgery patients, suprapubic catheters were found to decrease bacteriuria and discomfort and were preferred by patients.43 Although evidence suggests short-term benefit from silver alloy-impregnated and suprapubic catheters, their use remains somewhat controversial.