Your bladder is like a storage tank for the waste product urine (pee). When your bladder is full, you urinate and the waste leaves your body. But, if you have urinary retention, your bladder doesn’t completely empty when you pee. Things like blockages, medications or nerve issues can cause it.
Urinary retention is a condition where your bladder doesn’t empty all the way or at all when you urinate (pee). Your bladder is like a storage tank for your pee (or urine). Pee is made up of the waste that your kidneys filter from your body. After your kidneys make your pee, it moves to your bladder where it sits until you empty it. Your urethra is the tube that carries your pee from your bladder out of your body.
When you have urinary retention, it can be acute (sudden) or chronic (long-term). Acute means that it comes on quickly and it can be severe. Chronic urinary retention means that your symptoms are more gradual. Blockages, medications and nerve problems are common reasons a person may have urinary retention.
The acute form of urinary retention is an emergency. In this case, you’ll need to see a healthcare provider right away. Chronic urinary retention is most common in people assigned male at birth (AMAB) who are between 60 and 80 years old. But it can still occur in people assigned female at birth (AFAB).
About 10% of people AMAB over age 70 and up to 30% of people AMAB over 80 will develop urinary retention. While people AFAB can get acute urinary retention, it’s far less common.
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The signs can vary depending on if you have acute or chronic urinary retention.
With the acute form, symptoms come on more suddenly. You may not be able to pee at all, or only be able to go very small amounts even though you have a full bladder. In severe cases, it can cause digestive discomfort and lower abdominal pain. See a healthcare provider right away if this happens to you.
Symptoms of chronic urinary retention can vary from one person to another. Some symptoms include:
Urinary retention can happen for several different reasons. These causes can include:
When something blocks the free flow of urine through your bladder and urethra, you might experience urinary retention. Blockages (obstructions) are one of the most common causes of urinary retention.
Some reasons you may experience a blockage include:
Certain medications can cause urinary retention. Drugs like antihistamines (Benadryl®), antispasmodics (like Detrol®), opiates (like Vicodin®) and tricyclic antidepressants (like Elavil®) can change the way your bladder muscle works.
Other medications that may cause bladder control side effects are:
You may not know this, but your brain plays a role in urination. Passing urine happens when your brain tells your bladder muscle to tighten to squeeze your pee out. Your brain then tells your sphincter muscles surrounding your urethra to relax. This lets the flow of urine go out of your body. If there’s an issue in how your brain talks to your nerves, it can cause a problem with urination.
Causes of nerve issues can include:
You’re also at a higher risk of nerve issues if you’ve had a catheter (thin tube that removes pee directly from your bladder).
Infection and swelling (inflammation) can also affect how pee flows through your urethra. Some examples of urinary retention due to infection or inflammation are:
You may experience urinary retention after having joint replacement surgery (such as hip replacement) or spinal surgery. Having general anesthesia during a procedure can also cause temporary urinary retention.
Anyone can have urinary retention, but it occurs more often in people AMAB. People with an enlarged prostate (benign prostatic hyperplasia or BPH) are most likely to develop urinary retention because their prostates push on their urethras, blocking the flow of urine out of their bladder.
Left undiagnosed or untreated, urinary retention can lead to:
Acute urinary retention is a medical emergency. You should seek care right away if you have trouble urinating suddenly, especially if you feel pain in your abdomen or belly.
If you have chronic urinary retention, you’ll see a urologist who will:
There are other tests your provider may use to find the causes of urinary retention. These could include:
Treatment for urinary retention can depend on whether you have the acute form or the chronic form, as well as the cause.
Since the acute form of urinary retention is a medical emergency, your healthcare provider will insert a catheter to drain your bladder. This should provide almost immediate relief. After that, they’ll work to determine the cause and the appropriate treatment.
Treatment of the chronic form will depend on the cause. It could include one or a combination of the following:
It could also include temporarily using a catheter at home, especially if nerve issues are causing the urinary retention. Your provider will teach you how to self-catheterize.
Your provider may prescribe medication to treat the underlying cause of urinary retention. This could include medication for:
Surgical procedures may be necessary to treat urinary retention depending on the cause. Your provider may recommend surgery to treat things like:
Your healthcare provider will begin with less invasive procedures and treatments first. But, if none of these help, they may need to consider more invasive procedures like:
Sometimes, nonsurgical approaches can provide relief of your symptoms. Some examples of nonsurgical treatments could include:
You can’t prevent it, but you can take steps to lower your risk. Some of these steps include:
Yes, some people still pee a little bit. Urinary retention can mean either you don’t pee at all or you don’t empty your bladder completely when you pee. You may also pee because your bladder is overflowing with urine.
If you receive a urinary retention diagnosis, be sure to follow your provider’s treatment plan. Attend follow-up appointments and keep track of if your symptoms are improving. Many people find relief from their symptoms with the right treatment.
See your healthcare provider if you:
If you have urinary retention, it’s normal to have questions. You may want to ask your provider:
A note from Cleveland Clinic
It can feel uncomfortable talking about bladder control problems with your family, friends and healthcare providers. You’re not alone. Urinary retention is a common and treatable condition. If you notice changes in urination or you can’t pee at all, contact your healthcare provider. Several treatment options can help you manage your symptoms.
Last reviewed by a Cleveland Clinic medical professional on 01/23/2024.
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