Description, Causes and Risk Factors:
Urinary retention is the inability to empty the bladder. With chronic urinary retention, you may be able to urinate, but you have trouble starting a stream or emptying your bladder completely. You may urinate frequently; you may feel an urgent need to urinate but have little success when you get to the toilet; or you may feel you still have to go after you've finished urinating. With acute urinary retention, you can't urinate at all, even though you have a full bladder. Acute urinary retention is a medical emergency requiring prompt action. Chronic urinary retention may not seem life threatening, but it can lead to serious problems and should also receive attention from a health professional.
Anyone can experience urinary retention, but it is most common in men in their fifties and sixties because of prostate enlargement. A woman may experience urinary retention if her bladder sags or moves out of the normal position, a condition called cystocele. The bladder can also sag or be pulled out of position by a sagging of the lower part of the colon, a condition called rectocele. Some people have urinary retention from rectoceles. People of all ages and both sexes can have nerve disease or nerve damage that interferes with bladder function.
Acute urinary retention causes great discomfort, and even pain. You feel an urgent need to urinate but you simply can't. The lower belly is bloated.
Chronic urinary retention, by comparison, causes mild but constant discomfort. You have difficulty starting a stream of urine. Once started, the flow is weak. You may need to go frequently, and once you finish, you still feel the need to urinate. You may dribble between trips to the toilet because your bladder is constantly full, a condition called overflow incontinence.
There are two general causes of urinary retention: obstruction and non-obstruction. If there is an obstruction (for example, kidney stones), urine cannot flow freely through the urinary track. Non-obstructive causes include a weak bladder muscle and nerve problems that interfere with signals between the brain and the bladder. If the nerves aren't working properly, the brain may not get the message that the bladder is full. Even if you know that your bladder is full, the bladder muscle that squeezes urine out may not get the signal that it is time to push, or the sphincter muscles may not get the signal that it is time to relax. A weak bladder muscle can also cause retention.
Symptoms of urinary retention may include:
Weak dribble or stream of urine.
Loss of small amounts of urine during the day.
Inability to feel when bladder is full.
Increased abdominal pressure.
Lack of urge to urinate.
Strained efforts to push urine out of the bladder.
Nocturia (waking up more than two times at night to urinate).
Difficulty starting to urinate.
Diagnosis is obvious in patients who cannot void. In those who can void, diagnosis is by postvoid catheterization showing a residual urine volume > 100 mL. Other tests (eg, urinalysis, blood tests, ultrasonography, urodynamic testing, cystoscopy, cystography) are done based on clinical findings.
Relief of acute urinary retention requires urethral catheterization. Subsequent treatment depends on cause. In men with benign prostatic hypertrophy, drugs (usually ?-adrenergic blockers or 5?-reductase inhibitors) or surgery may help decrease bladder outlet resistance. No treatment is effective for impaired bladder contractility or a neurogenic bladder; intermittent self-catheterization or indwelling catheterization is usually required. Urinary diversion is a last resort.
Some people can reduce their symptoms of urinary retention with lifestyle changes, fluid and diet modification, bladder retraining, Kegel exercises or other kinds of physical therapy.
DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.
A new Finnish study, published in the journal Frontiers in Microbiology, finds that endurance exercises may change the composition of gut microbiota. The researchers developed a 6-week program of bicycle training and enrolled 17 overweight women for this program. All...
In summer and spring it is easy to get up early and run a couple of laps, do a few push-ups and, with a sense of accomplishment, go to work. But in autumn, when there are dark clouds in sky, a cold wind is blowing and it is boring rain, you probably not feel like...
It is very entertaining to be a sport fan. There is a big variety of sport games that are extremely interesting to follow. Moreover, it is always fun to anticipate the score and watch the enthusiasm live. One of the benefits of being sports fan is using different...read more
A new study of nearly 18,000 participants found that those with high fitness at middle age were significantly less likely to die from heart disease in later life, even if they were diagnosed with depression. Doctor's Tips: How to Stay Fit While Treating Depression Dr....read more
The warm ups are supposed to increase body temperature and blood flow so the muscles and surrounding joints become more responsive and prepared for physical activity. Although there’s a neurological element to warm-ups, most research focuses on the physiological...read more