What happens?

One of the most unpleasant medical conditions, urine retention is not something anyone wants to suffer. It occurs acutely or chronically. In acute urine retention the bladder fills up and someone feels the need to go and pass water. They can't, and this build-up of urine causes great pain.

In chronic retention it's possible for someone to pass very small quantities of urine, but this is difficult, and the bladder never completely empties. Over time urine collects in the bladder. However, with chronic retention of urine the condition is usually painless.

Blocking the flow

Anything that prevents the normal flow of urine from the bladder through the urethra (the tube through which urine passes) to the outside can cause urine retention to occur.

It may be a stone in the bladder that, by acting like a bath-plug, prevents urine from leaving the bladder, or retention may be a side effect of medication being taken to treat another medical problem.

Nerve damage that arises as a result from a complication of conditions such as diabetes or multiple sclerosis may mean that the nerves that control bladder performance function poorly or not at all.

In men the most common cause of urine retention is enlargement of the prostate gland. This causes pressure on the urethra and a reduction in urine flow, in the same way that putting a kink in a hosepipe reduces the flow of water.

Other obstructions of urine include a narrowing of the urethra that may arise because of infection or inflammation, or a tightening of the foreskin, called phimosis. Constipation may also restrict the flow of urine because faeces in the rectum press on the urethra.

Pressure

In acute urine retention the symptoms develop very quickly and may include:

  • lower abdominal pain
  • lower abdominal "fullness"
  • a painful urge to pass urine but the inability to do so

Chronic urine retention may feel uncomfortable but is not usually painful. Over a period of time the following symptoms may develop:

  • abdominal swelling
  • frequent sensation of wanting to pass urine
  • difficulty in starting to pass urine
  • weak flow of urine
  • dribbling at the end of passing urine and between times of passing urine

Big relief

Relief of urine retention is gained by inserting a catheter into the bladder to allow the bladder to empty. It's important to establish what was responsible for the problem and to treat this so that problems cannot occur again. This may involve specialist tests of the bladder, for example intravenous urography or cystoscopy, which will identify any cause such as bladder stones. Other tests performed examine the urine and measure urine flow.

If the cause of the problem is not treatable then it may be necessary for intermittent catheterisation to be performed or a permanent catheter to be left in place to ensure that the bladder is emptied regularly.

 
 
 
 
By Dr_Rob-Hicks 01/29/2016 12:54:00

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