What to know about urinary retention
Sometimes a chronic issue, such as a pelvic floor or prostate problem, causes urinary retention. Acute issues, such as infections, may also cause urinary retention.
Keep reading to learn more about the causes, symptoms, and treatment of urinary retention.
A person with chronic urinary retention may need to urinate repeatedly in a short period.
Many different conditions and other factors can cause urinary retention, including:
- blockages in the urinary tract, such as those from bladder stones
- swelling of the urethra due to an infection or injury
- nerve damage that interferes with the brain's ability to communicate with the urinary system, which can occur following a spinal cord injury
- prostate issues, such as benign prostatic hyperplasia, prostatitis, or prostate cancer
- medications that affect the nervous system
- severe constipation that compresses the urethra or bladder
- anesthesia, which may temporarily affect nerves and cause urinary retention
- cystocele, which causes the bladder to droop partially into the vagina, putting pressure on the bladder
- pelvic floor issues that affect muscle strength or nerve function, including injuries following childbirth or other physical traumas
People with urinary retention struggle to empty the bladder. There are two types of urinary retention: chronic and acute.
Chronic urinary retention
This form of the condition develops gradually over months or years and lasts for a long time. The symptoms of chronic urinary retention include:
- difficulty urinating, which may be constant or sporadic
- needing to urinate again shortly after using the bathroom
- having to strain to urinate
- a weak stream of urine or a stream of urine that stops and starts
- not noticing the sensation to urinate and, therefore, not emptying the bladder
- repeatedly urinating in a short period
- urinating more than eight times per day
- incontinence, especially if a person does not seek treatment for urinary retention
Acute urinary retention
Acute urinary retention is a medical emergency that may occur due to a total blockage in the urethra or another part of the urinary system. Symptoms include:
- a total inability to urinate
- an intense need to urinate or the feeling that the bladder is full
- swelling or pain in the stomach
Some people with acute urinary retention also have symptoms of an infection, such as a fever or chills. However, even without these symptoms, it is important to seek immediate treatment.
Some people do not notice any symptoms of urinary retention until they develop incontinence. People who have unexplained incontinence should, therefore, also see a doctor.
Treating urinary retention begins with diagnosing the cause. A urine sample sometimes reveals an infection, but usually, a doctor must perform several tests to diagnose the cause. These tests include:
- a prostate exam for males
- a physical exam to look for signs of infection or injury
- a complete medical history check
- voiding tests to examine what the urinary system is doing during urination
- a cystoscopy, which involves the use of a thin instrument to look inside the bladder and urethra
- imaging scans that help a doctor see the bladder, urethra, and, sometimes, the kidneys
A person should be sure to tell the doctor if they have any common risk factors for urinary retention, including recent injuries, a prior history of urinary retention, prostate issues, and cystocele.
The right treatment depends on the cause. Some causes of urinary retention are more easily treatable than others. Some treatments that a doctor might recommend include:
- antibiotics for a urinary tract infection
- physical therapy for pelvic floor dysfunction
- changing medications when a prescription drug is the culprit
- using a catheter to drain the bladder
- a surgical procedure called urethral dilation that treats a blocked or constricted urethra
- inserting a tube called a stent into the urethra to prevent future blockages
- surgery to remove enlarged prostate tissue, prostate growths, or even the prostate
- surgical repair of a cystocele
Sometimes, a doctor may also recommend lifestyle changes, such as drinking more water, using the bathroom when the urge first arises, or increased physical activity.
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:
- urinary tract infections
- using certain medications, such as anticholinergics, antihistamines, and some decongestants
- giving birth, especially when the delivery causes trauma or injury
- weak bladder muscles due to age, inactivity, or injury
- nerve damage and disorders that can damage the nerves, such as diabetes
Urinary retention can be painful and inconvenient. When it appears suddenly and leaves a person unable to urinate, it can be excruciating and very scary.
Delaying treatment only allows the condition to get worse. Urinary retention is treatable, and there is no need to feel embarrassed or ashamed.
A doctor can often diagnose the problem. However, in some cases, a person may need a referral to a urologist, proctologist, or pelvic floor specialist for further testing and treatment.