Urinary Retention: What is it and What Should I do about It?

If you have ever felt as though you had to pee but couldn’t, you are not imagining things. Thousands of people are affected by urinary retention, a condition that makes it difficult to fully empty their bladder. How serious this condition is depends on a number of issues, which is why it is important to recognize the symptoms and causes.

Acute vs. Chronic Urinary Retention

Urinary retention may be either chronic or acute. Chronic urinary retention develops over a longer period of time, and is characterized by being unable to fully empty your bladder. If you are suffering from chronic urinary retention, you may:

  • Have difficulty starting a stream
  • Notice smaller amounts of urine than normal
  • Feel as though you still have to go once you are finished urinating

Acute urinary retention comes on very suddenly, and occurs whenever you are unable to pass any urine whatsoever.  It is often accompanied by severe abdominal or lower back pain. This is a life-threatening condition that requires immediate medical attention.

What Causes Urinary Retention?

An enlarged prostate is the most common cause of urinary retention, and is the primary reason it affects men more often than women. When the prostrate becomes enlarged, it presses on the urethra, which is the tube responsible for carrying urine out of the body. Other causes can include:

  • Bladder stones
  • Urinary tract infection
  • Nerve problems such as those caused by diabetes mellitus
  • Herpes and other sexually-transmitted diseases
  • Alcoholism
  • Side effect of certain medications

Diagnosing Urinary Retention

Several methods are used to diagnose urinary retention, including:

  • A physical examination of the prostate area
  • Performing an ultrasound to measure the amount of urine remaining in the bladder after you pee
  • X-rays and CT scans
  • Urodynamic tests to measure how effectively the urethra and bladder hold and release urine

Treating Urinary Retention

To treat urinary retention, we must first determine the underlying cause for it. A number of treatment options including catheterization to drain the bladder or medication to eliminate infection can be performed right here in our office. When urinary retention is due to a side effect of medication, additional drugs may be prescribed to relax the bladder neck muscles.

More serious cases of urinary retention could require a surgical procedure to:

  • Eliminate an enlarged prostate, or remove tumors or other obstructions
  • Widen the urethra so that more urine can pass through (a procedure known as urethral dilation.)
  • Placing stents or artificial tubes in the urethra to keep it open
  • Lift a fallen bladder (a type of surgery often performed on women who are plagued with urinary retention)
  • Insert a special catheter into the urethra (this is called an internal urethrotomy)

Do not avoid getting treatment because you are anxious about having a physical exam or surgical procedure. The sooner you seek help, the less invasive your treatment plan is likely to be. For example, medication can often be used to treat an enlarged prostrate when it is caught early, but surgery might be required if you wait too long.