Urinary retention can be an emergency condition requiring immediate medical attention.
The urinary system consists of a group of organs that work together to eliminate waste from the body. This physiological process originates in the kidneys which function as an intricate filtration system. As blood flows into the kidneys, waste products in the blood are filtered and excreted from the kidneys as urine. Urine is then moved down the ureters into the bladder for storage. At the appropriate time, it will be voluntarily disposed of through the urethra during urination.
Urine that is stored in the bladder, which is not being properly eliminated from the body, is known as urinary retention. Urinary retention is considered an emergency medical condition because it disrupts the natural flow of urine, and the normal functioning of the urinary system. Urinary retention is extremely uncomfortable and will trigger severe pain as the bladder continues to stretch and fill with urine. Damage to the bladder or kidneys is possible, and if urinary retention is prolonged and severe, it can result in kidney failure.
Urinary retention is characterized as being either acute or chronic. It may strike suddenly and intensely (acute), as the result of a blockage, or it may be chronic and ongoing as a result of an enlarged prostate. Acute retention must be treated immediately to relieve symptoms and avoid organ damage. Chronic retention is generally treated over a longer period of time to either remedy or manage the condition.
There is a long list of factors that may cause urinary retention. Some of these include:
- Blockage caused by bladder or kidney stones
- Blockage due to excess prostate tissue (Enlarged prostate / BPH)
- Cystocele – a prolapsed bladder
- Rectocele – a prolapsed rectum
- Chronic constipation
- Benign or malignant tumors
- Medications – prescribed or over-the-counter
- Urethral stricture – when the urethra narrows
- Neurological damage
When urinary retention occurs, it’s important to be examined by a qualified healthcare professional as soon as possible. Urologists regularly treat patients with retention, and rely on several evaluation tools to assist in their diagnosis.
- CT imaging – Helps the provider locate stones, tumors, or other cysts.
- Cystoscopy – Allows the provider to look into the bladder and identify urethral strictures.
- Electromyography – Measures the electrical function of nerves and muscles associated with the bladder and sphincter muscles.
- Urodynamics – An in-office series of tests to evaluate how well urine is stored and released.
- Uroflowmetry – Testing that evaluates urine volume and flow rate.
The goal of treatment is to drain urine that is being stored, and to relieve pressure off the urinary organs. In cases of acute retention, catheterization is routinely performed. However, inserting a catheter during retention should always be done by a qualified medical professional. Patients should never attempt to self-catheterize to relieve symptoms.
There are several approaches to relieving urinary retention, including:
- Short or long-term catheterization.
- Medications designed to shrink an enlarged prostate (benign prostatic hyperplasia).
- In-office or surgical procedures to remove excess prostate tissue associated with BPH.
- Elimination of bladder or kidney stones to restore urine flow.
- Dilation of the urethra.
- Urethra stent placement.
- Surgical correction of a cystocele or rectocele.
- Managing chronic constipation.
If you or someone you know are unable to urinate, are experiencing severe bladder, groin, or abdominal pain, abdominal swelling, nausea, or profuse sweating, seek emergency medical attention by contacting us by phone, visiting the Urology Austin office nearest you, a local hospital or free-standing emergency room.