Summary about Disease
Urinary retention is the inability to completely empty the bladder. It can be acute (sudden onset) or chronic (gradual development). It can affect both men and women but is more common in men, especially as they age. It can lead to discomfort, pain, and potential complications like urinary tract infections and bladder damage.
Symptoms
Acute Urinary Retention:
Sudden inability to urinate
Severe lower abdominal pain
Urgency
Bladder distention
Chronic Urinary Retention:
Frequent urination (especially at night)
Difficulty starting a urine stream
Weak urine stream
Feeling of incomplete bladder emptying
Dribbling of urine
Mild, constant discomfort in the lower abdomen
Causes
Obstruction:
Enlarged prostate (benign prostatic hyperplasia - BPH)
Urethral stricture (narrowing of the urethra)
Bladder stones
Tumors in the bladder or pelvis
Constipation (especially in children)
Nerve Problems:
Spinal cord injury
Stroke
Multiple sclerosis
Diabetes
Surgery (especially pelvic surgery)
Medications that affect bladder function
Medications:
Antihistamines
Decongestants
Antidepressants
Anticholinergics
Opioid pain relievers
Infections:
Prostatitis (inflammation of the prostate gland)
Urinary tract infections (UTIs) can sometimes cause temporary retention
Medicine Used
Alpha-blockers: These medications (e.g., tamsulosin, alfuzosin) relax the muscles in the prostate and bladder neck, making it easier to urinate, especially in cases of BPH.
5-alpha reductase inhibitors: These medications (e.g., finasteride, dutasteride) shrink the prostate gland over time, also used for BPH.
Cholinergic medications: (e.g., bethanechol) These can help stimulate bladder muscle contraction in some cases of neurogenic bladder. Use cautiously as they can have side effects.
Antibiotics: If a UTI is present, antibiotics will be prescribed to treat the infection.
Pain relievers: Over-the-counter or prescription pain relievers may be used to manage discomfort.
Is Communicable
No, urinary retention itself is not a communicable disease. However, if it's caused by a UTI, the infection could potentially be transmitted, but urinary retention as a condition isn't contagious.
Precautions
Maintain a healthy lifestyle: Regular exercise, a balanced diet, and adequate hydration can help prevent some causes of urinary retention.
Manage underlying conditions: Control diabetes, multiple sclerosis, or other neurological conditions that may contribute to bladder dysfunction.
Avoid medications that worsen retention: If possible, limit the use of medications known to cause urinary retention, or discuss alternatives with your doctor.
Promptly treat UTIs: Seek medical attention for urinary tract infections to prevent complications.
Regular prostate exams: Men should discuss prostate health with their doctor, especially as they age.
Proper catheter care: If a catheter is necessary, follow instructions carefully to prevent infection.
How long does an outbreak last?
There isn't an "outbreak" of urinary retention. Acute urinary retention is a sudden event that requires immediate medical attention. Chronic urinary retention can be an ongoing condition that lasts for months or years, depending on the underlying cause and treatment.
How is it diagnosed?
Medical history and physical exam: The doctor will ask about symptoms, medical history, and perform a physical examination, including abdominal palpation to check for bladder distention.
Post-void residual (PVR) measurement: This test measures the amount of urine left in the bladder after urination, usually using ultrasound or catheterization.
Urinalysis: This test checks for signs of infection or other abnormalities in the urine.
Urine flow study (uroflowmetry): This test measures the rate and amount of urine flow.
Cystoscopy: A thin, flexible tube with a camera is inserted into the urethra to visualize the bladder and urethra.
Imaging studies: Ultrasound, CT scans, or MRI scans may be used to identify blockages or other abnormalities.
Neurological exam: This may be performed if nerve problems are suspected.
Timeline of Symptoms
Acute Retention: Symptoms develop suddenly, typically over a few hours. The individual experiences an inability to urinate and significant lower abdominal pain.
Chronic Retention: Symptoms develop gradually, often over weeks, months, or even years. The individual may experience a weak stream, frequent urination, a feeling of incomplete emptying, and dribbling. The specific timeline depends on the underlying cause and its progression.
Important Considerations
Prompt treatment is crucial: Acute urinary retention is a medical emergency that requires immediate intervention to prevent bladder damage and other complications.
Underlying cause must be identified: Effective treatment depends on identifying and addressing the underlying cause of the retention.
Self-catheterization: In some cases, intermittent self-catheterization may be necessary to empty the bladder regularly. Proper training and hygiene are essential to prevent infection.
Long-term management: Chronic urinary retention may require long-term management and monitoring to prevent complications.
Individualized treatment plan: The treatment plan should be tailored to the individual's specific needs and underlying condition.
Medication side effects: Be aware of the potential side effects of medications used to treat urinary retention and discuss any concerns with your doctor.