Urinary retention
Urinary retention is an inability to completely empty the bladder. Onset can be sudden or gradual. When of sudden onset, symptoms include an inability to urinate and lower abdominal pain. When of gradual onset, symptoms may include loss of bladder control, mild lower abdominal pain, and a weak urine stream. Those with long-term problems are at risk of urinary tract infections.
| Urinary retention | |
|---|---|
| Other names | Ischuria, bladder failure, bladder obstruction |
| Urinary retention with greatly enlarged bladder as seen by CT scan. | |
| Specialty | Emergency medicine, urology |
| Symptoms | Sudden onset: Inability to urinate, low abdominal pain Long term: Frequent urination, loss of bladder control, urinary tract infection |
| Types | Acute, chronic |
| Causes | Blockage of the urethra, nerve problems, certain medications, weak bladder muscles |
| Diagnostic method | Amount of urine in the bladder post urination |
| Treatment | Catheter, urethral dilation, urethral stents, surgery |
| Medication | Alpha blockers such as terazosin, 5α-reductase inhibitors such as finasteride |
| Frequency | 6 per 1,000 per year (males > 40 years old) |
Causes include blockage of the urethra, nerve problems, certain medications, and weak bladder muscles. Blockage can be caused by benign prostatic hyperplasia (BPH), urethral strictures, bladder stones, a cystocele, constipation, or tumors. Nerve problems can occur from diabetes, trauma, spinal cord problems, stroke, or heavy metal poisoning. Medications that can cause problems include anticholinergics, antihistamines, tricyclic antidepressants, cyclobenzaprine, diazepam, nonsteroidal anti-inflammatory drugs (NSAID), amphetamines, and opioids. Diagnosis is typically based on measuring the amount of urine in the bladder after urinating.
Treatment is typically with a catheter either through the urethra or lower abdomen. Other treatments may include medication to decrease the size of the prostate, urethral dilation, a urethral stent, or surgery. Males are more often affected than females. In males over the age of 40 about 6 per 1,000 are affected a year. Among males over 80 this increases 30%.