Urinary retention
| Urinary retention | |
|---|---|
| Other names | Ischuria, bladder failure, bladder obstruction |
| Urinary retention with greatly enlarged bladder as seen by CT scan. | |
| Specialty | Emergency medicine, urology |
| Symptoms | Sudden onset: Inability to urinate, low abdominal pain[1] Long term: Frequent urination, loss of bladder control, urinary tract infection[1] |
| Types | Acute, chronic[1] |
| Causes | Blockage of the urethra, nerve problems, certain medications, weak bladder muscles[1] |
| Diagnostic method | Amount of urine in the bladder post urination[1] |
| Treatment | Catheter, urethral dilation, urethral stents, surgery[1] |
| Medication | Alpha blockers such as terazosin, 5α-reductase inhibitors such as finasteride[1] |
| Frequency | 6 per 1,000 per year (males > 40 years old)[1] |
Urinary retention is an inability to completely empty the bladder.[1] Onset can be sudden or gradual.[1] When of sudden onset, symptoms include an inability to urinate and lower abdominal pain.[1] When of gradual onset, symptoms may include loss of bladder control, mild lower abdominal pain, and a weak urine stream.[1] Those with long-term problems are at risk of urinary tract infections.[1]
Causes include blockage of the urethra, nerve problems, certain medications, and weak bladder muscles.[1] Blockage can be caused by benign prostatic hyperplasia (BPH), urethral strictures, bladder stones, a cystocele, constipation, or tumors.[1] Nerve problems can occur from diabetes, trauma, spinal cord problems, stroke, or heavy metal poisoning.[1] Medications that can cause problems include anticholinergics, antihistamines, tricyclic antidepressants, cyclobenzaprine, diazepam, nonsteroidal anti-inflammatory drugs (NSAID), stimulants, and opioids.[1][2] Diagnosis is typically based on measuring the amount of urine in the bladder after urinating.[1]
Treatment is typically with a catheter either through the urethra or lower abdomen.[1][3] Other treatments may include medication to decrease the size of the prostate, urethral dilation, a urethral stent, or surgery.[1] Males are more often affected than females.[1] In males over the age of 40 about 6 per 1,000 are affected a year.[1] Among males over 80 this increases 30%.[1]
- ^ a b c d e f g h i j k l m n o p q r s t u v w "Urinary Retention". National Institute of Diabetes and Digestive and Kidney Diseases. August 2014. Archived from the original on 4 October 2017. Retrieved 24 October 2017.
- ^ de Jong AC, Maaskant JM, Groen LA, van Woensel JB (January 2021). "Monitoring of micturition and bladder volumes can replace routine indwelling urinary catheters in children receiving intravenous opioids: a prospective cohort study". European Journal of Pediatrics. 180 (1): 47–56. doi:10.1007/s00431-020-03703-7. PMC 7782390. PMID 32529397.
- ^ Sliwinski A, D'Arcy FT, Sultana R, Lawrentschuk N (April 2016). "Acute urinary retention and the difficult catheterization: current emergency management". European Journal of Emergency Medicine. 23 (2): 80–88. doi:10.1097/MEJ.0000000000000334. PMID 26479738. S2CID 26988888.