Urinary Retention

Urinary retention occurs when you cannot empty all the urine from your bladder. The bladder is a hollow organ that stores urine until you're ready to release it. When working properly, nerve signals tell your brain when your bladder is full, and you can control when to urinate.

In urinary retention, this process is disrupted. The condition can range from being unable to start urination, having a weak stream, or feeling like you haven't completely emptied your bladder. In severe cases, you may not be able to urinate at all despite having a full bladder.

Acute urinary retention is a medical emergency that develops suddenly and can be extremely painful. Chronic urinary retention develops gradually and may cause few symptoms initially, making it harder to detect but potentially leading to serious complications over time.

Acute Urinary Retention

Chronic Urinary Retention

Acute Retention Symptoms

• Complete inability to urinate: Despite strong urge
• Severe pain: Lower abdomen and pelvic area
• Visible bladder distention: Swelling above pubic bone
• Extreme discomfort: Restlessness and anxiety
• Sweating: Due to pain and distress
• Rapid heartbeat: From pain and anxiety

Chronic Retention Symptoms

• Frequent urination: Small amounts throughout day
• Difficulty starting: Straining to begin urination
• Weak stream: Slow or dribbling flow
• Intermittent stream: Starting and stopping
• Incomplete emptying: Feeling of fullness after urinating
• Urgency: Sudden, strong need to urinate
• Nocturia: Waking frequently at night to urinate
• Overflow incontinence: Leaking when bladder is full
• Abdominal discomfort: Mild pressure or fullness

Warning Signs of Complications

• Back pain (kidney involvement)
• Fever and chills (infection)
• Blood in urine
• Nausea and vomiting
• Confusion (in elderly)
• Severe fatigue

Obstructive Causes

In Men

• Benign prostatic hyperplasia (BPH): Enlarged prostate
• Prostate cancer: Tumor blocking urethra
• Prostatitis: Prostate inflammation
• Urethral stricture: Narrowing of urethra
• Phimosis: Tight foreskin

In Women

• Pelvic organ prolapse: Cystocele, rectocele
• Pelvic masses: Fibroids, ovarian cysts
• Urethral stricture: Less common than in men
• Previous pelvic surgery: Scar tissue

In Both Genders

• Bladder stones: Blocking bladder outlet
• Tumors: Bladder or pelvic tumors
• Blood clots: In bladder
• Severe constipation: Pressure on urethra
• Foreign objects: In urethra

Non-obstructive Causes

Neurological Conditions

• Spinal cord injury: Disrupted nerve signals
• Multiple sclerosis: Nerve damage
• Parkinson's disease: Affects bladder control
• Stroke: Brain damage affecting bladder
• Diabetic neuropathy: Nerve damage from diabetes
• Spina bifida: Birth defect affecting nerves
• Cauda equina syndrome: Compressed nerves

Medications

• Anticholinergics: Reduce bladder contractions
• Antihistamines: Allergy medications
• Decongestants: Alpha-adrenergic agonists
• Antidepressants: Tricyclics, SSRIs
• Antipsychotics: Affect nerve signals
• Muscle relaxants: Reduce bladder muscle tone
• Opioids: Pain medications
• Anesthetics: During/after surgery

Other Causes

• Infections: Severe UTIs, prostatitis
• Trauma: Pelvic injuries
• Childbirth: Nerve or muscle damage
• Surgery: Pelvic or spinal procedures
• Psychological factors: Severe anxiety, trauma

Medical History

• Onset and duration of symptoms
• Urination patterns and frequency
• Associated pain or discomfort
• Medications (prescription and OTC)
• Previous urological problems
• Surgical history
• Neurological symptoms
• Sexual function

Physical Examination

• Abdominal exam: Palpate for distended bladder
• Digital rectal exam: Check prostate in men
• Pelvic exam: In women for prolapse or masses
• Neurological exam: Test reflexes and sensation
• External genitalia: Check for abnormalities

Diagnostic Tests

• Post-void residual (PVR): Ultrasound or catheter measurement
• Urinalysis: Check for infection or blood
• Urine culture: Identify bacteria
• Blood tests: Kidney function, PSA
• Uroflowmetry: Measure urine flow rate
• Cystoscopy: Visual examination of bladder
• Urodynamic studies: Bladder pressure testing
• Imaging: Ultrasound, CT, or MRI

Bladder Health Tips

• Don't delay urination: Go when you feel the urge
• Take your time: Allow complete emptying
• Double void: Try to urinate again after finishing
• Proper positioning: Sit properly on toilet, lean forward slightly
• Stay hydrated: But avoid excessive fluids before bed
• Avoid bladder irritants: Caffeine, alcohol, spicy foods
• Manage constipation: Can worsen retention
• Pelvic floor exercises: Strengthen bladder muscles

Medication Management

• Review all medications with doctor
• Be cautious with OTC cold medicines
• Report urinary problems promptly
• Don't stop prescribed medications without consulting doctor
• Consider medication timing adjustments

Lifestyle Modifications

• Weight management: Reduce pressure on bladder
• Exercise regularly: Improves overall health
• Quit smoking: Reduces bladder irritation
• Limit alcohol: Can worsen retention
• Manage chronic conditions: Diabetes, neurological issues
• Stress management: Can affect bladder function

See Your Doctor Soon If:

• Difficulty starting urination
• Weak or intermittent stream
• Feeling of incomplete emptying
• Frequent urination with small amounts
• New onset of urinary problems
• Recurrent UTIs
• Progressive worsening of symptoms

• Urinary tract infections: From retained urine
• Bladder damage: Stretching and loss of muscle tone
• Kidney damage: From backflow of urine
• Bladder stones: From stagnant urine
• Chronic kidney disease: Long-term retention
• Sepsis: Severe infection spreading to blood
• Hydronephrosis: Swelling of kidneys
• Quality of life impact: Social and emotional effects