Urinary retention is the inability to empty one’s bladder.  It can occur in both men and women however men have a higher incidence of it primarily due to the enlargement of the prostate gland in men as they age.

Acute and chronic urinary retention

There are two forms of urinary retention – acute or chronic. 

Acute urinary retention happens suddenly and often causes pain when attempting to void in response to a full bladder but a man find he is unable to.  This type of urinary retention can be life threatening and does require immediate medical attention.  A man will generally have a great deal of discomfort and pain with acute urinary retention.

Chronic urinary retention develops slowly over time and is a painless retention of urine.  Men who have chronic urinary retention can urinate but they do not completely empty all of the urine from their bladder.  Most men will not even know they have a problem with chronic urinary retention until they develop another problem.  This could be incontinence, a urinary tract infection or an illness caused by harmful bacteria growing in the urinary tract. 

Risk factors associated with urinary retention

There can be several different risk factors as to why a man may develop urinary retention which include:

·         An enlarged prostate or benign prostatic hyperplasia (BPH)

·         A blockage such as a bladder stone or a narrowing of the urethra

·         Weak bladder muscles

·         Nerve damage from diabetes, stroke, or spinal cord injury

·         Bladder diverticula – pockets of urine forming in the bladder that do not empty

·         Certain medication such as narcotics, antihistamines, or antidepressants

·         As a result of surgery from the anesthetic or the type of operation

Symptoms associated with urinary retention

In chronic urinary retention, a man may have no symptoms but men with acute, will have more noticeable symptoms which include:

·         Frequent urination

·         Urge to urinate but either urine does not come out or it dribbles out slowly and weakly

·         Frequent urine leaks while sleeping

·         Pain or pressure during urination

·         Pain or stiffness in the abdomen, lower back, hips, or upper thighs

·         Blood in the urine

Seeking medical help

Any man who experiences any of the symptoms associated with urinary retention needs to seek the advice of a urologist.  Urologists are medical doctors who specialize in the urinary tract system and are knowledgeable in treating urinary retention. 

Once a man describes his symptoms and urinary retention is suspected, he will be examined by the doctor pressing onto his lower abdomen feeling the bladder.  A scan of the bladder will be conducted to determine how much urine is in the bladder, along with blood or urine test, a post void residual test and possibly a digital rectal exam.

Treating urinary retention

Treating and the prognosis of urinary retention will depend on the source of the problem.    If it is caused by an obstruction, infection, drugs or from surgery it is usually more treatable than if it is associated with a nerve problem. 

If urinary retention continues even after initial treatments, a man may require long-term therapy such as the use of a foley catheter.  This small, flexible rubber or silicone tube drains urine from body into a bag.  This can be a temporary treatment until normal urination returns.  A healthcare professional will instruct a man on how to use it, how often to drain it along with other instructions on preventing urine from flowing back into the bladder causing an infection.

Another treatment that can be used are medications.  These medications can reduce the size of the prostate, help fight an infections or can help a man urinate more easily.

Surgery is another option if medication and a catheter do not relieve urinary retention.

Can urinary retention be prevented?

There are some steps a man can take to possibly prevent urinary retention to begin with.  It is essential to have good urination habits to keep the bladder functioning normally.

·         Avoid frequent holding of urinating for prolonged periods.  This can weaken bladder muscles because of overstretching due to a buildup of urine in the bladder.

·         Excess alcohol intake may lead to increased urine production and overdistention of the bladder.

·         Do Kegel exercises which involve squeezing and relaxing the muscle of the pelvic floor and are a good way to maintain lifelong bladder control.

·         Over-the-counter cold medications containing antihistamines and pseudoephedrine can increase the risk of urinary retention in men with prostate enlargement.