Urinary retention is characterized by inability of the individual to completely empty the bladder. It can either be acute or chronic in nature.
Individuals suffering from urinary retention have problem in emptying their bladder. They may also face difficulty in starting urination. There is a decreased ability to sense when the bladder is full. As a result, the chances of dribbling are very high. Small amounts of urine may leak when there is an increase in abdominal pressure on coughing or sneezing. Affected individuals also complain of increase in urge to urinate and have to wake up more than 3 to 4 times in the night to urinate.
At the preliminary level, tests are employed to analyse urinary flow in order to detect the nature of abnormality that has set in. This is done through ultrasound of the bladder that reveals a slow and intermittent flow with large quantity of urine retained in the bladder after complete voiding. If the amount of urine retained after voiding is more than 50ml, then the chances of contracting urine infections is pretty high .
In addition, determining the serum levels of prostate specific antigen helps rule out prostate cancer. Biopsy of the prostate is also helpful in making a definite diagnosis. In addition, serum levels of creatinine and urea may be required to determine kidney damage .
The following are employed for treating urinary retention:
Prognosis of the condition depends on the underlying etiology. If infections are the cause, then treating them helps in resolving the condition of urinary retention. Even after successful completion of treatment, chances of recurrence of urinary retention are pretty high . Surgical procedures are often beneficial for correcting the underlying problem; however there are some associated risks.
Urinary retention can occur due to some kind of obstruction that causes blockage in the pathway. These factors include cancer, kidney stones and an enlarged prostate gland .
Factors that favor the onset of non-obstructive urinary retention include vaginal birth, injury or trauma to the pelvic region, nerve dysfunction and accidents that cause injury to the spinal cord or brain. Urinary tract infections and various pharmacologic agents also pave way for development of urinary retention. It was studied that men who frequently succumb to non-steroidal anti-inflammatory drugs are twice more likely to develop acute urinary retention than those who do not.
Elderly males are more prone to suffer from urinary retention. It is one of the most common problems of urologic emergency department. Studies have shown that about 75% males aged 70 years and above experience some form of benign prostrate hyperplasia. The incidence increases by 33% in males aged 80 years and above .
In young adults, the cause of urinary retention is onset of acute prostatitis. In US, about 1-3% of males aged 40 or below suffer from an attack of urinary retention due to acute prostatitis. Acute urinary tract infections, advanced stage of clinical benign prostrate hyperplasia and consequent renal failure are significantly associated with increase rate of morbidity and mortality .
Urinary retention can be a result of obstructive or non-obstructive factors. Benign prostatic hyperplasia is considered to be one of the most common causes of urinary retention in men. In this condition, there is obstruction in the neck of the bladder which occurs due to prostate enlargement or constriction of prostatic urethra.
In women, urinary retention can occur either due to pelvic organ prolapse or uterine prolapse. Foreign bodies, development of stones and or urethral strictures can directly block urinary flow causing urinary retention in both men and women.
For the bladder to function normally, the interaction between the somatic nerves, brain and autonomic nervous system should work with proper coordination. Factors that interfere with this coordination can lead to urinary retention. Impaired innervation causes neurogenic bladder which is a condition common in both men and women .
Some of the causes of urinary retention can be prevented to avoid its onset. For example, appropriate management of benign prostate hyperplasia by regular medications can prevent onset of urinary retention. Women are advised to strengthen the pelvic muscles through exercises if they are suffering from pelvic organ prolapse.
Urinary retention is also known as ischuria. Acute urinary retention has a sudden onset and is painful with a shorter duration. On the other hand, chronic urinary retention lasts for longer periods and is not painful. Urinary retention is often a common accompaniment of benign prostatic hyperplasia. If the condition is not timely diagnosed, it can lead to infections and in advanced stages renal failure can also occur .
Urinary retention is a condition wherein the affected individual is unable to empty his bladder. It can be either acute or chronic in nature. Various factors that cause urinary retention include development of kidney stones that block urinary flow, cancer, benign prostate hyperplasia. In addition, infections, medications and nerve dysfunction can also lead to urinary retention. Symptoms include an inability to completely empty the bladder, frequent urination, pain or discomfort in the lower abdomen, dribbling and a weak or interrupted urine flow. Treatment is by medications, insertion of catheter or in some cases, surgery.