What is urinary retention?

Urinary retention is when the bladder (where you store your urine or 'water') does not empty all the way or at all. It can be acute (sudden) or chronic (long-term). Acute means it comes on real quick or is very bad. Chronic means you have had it for a while.

The acute form is an emergency. You need to see a doctor right away. The chronic form occurs most of the time in older men, but it can also occur in women.

What causes chronic urinary retention?

There is more than one cause. It can happen when something blocks the free flow of urine through the bladder and urethra. The urethra is the tube that takes urine from the bladder out of the body. The problem can also be caused by using drugs such as antihistamines (like Benadryl®), antispasmodics (like Detrol®), and tricyclic antidepressants (like Elavil®) that can change the way the bladder muscle works.

Passing your urine occurs when the brain tells the bladder muscle to tighten. This squeezes urine from the bladder. The brain then tells the sphincter muscles to relax. This lets the flow of urine go through the urethra and out of the body. Anything that gets in the way on the path from the brain to the nerves that go to the bladder and the urethra can also cause this problem. Urinary retention from nerve disease occurs at the same rate in men and women.

Blockage. In men, a blockage can be caused when the prostate gland gets so big that it presses on the urethra. This is the most common cause of the chronic form in men. One cause in women is a bladder that sags. This is called a cystocele. It can also be caused when the rectum sags into the back wall of the vagina. This is called a rectocele.

Some causes can happen to both men and women. The urethra can get narrow. This is called a stricture. Urinary stones can also block the flow of urine.

Infection and swelling. In men, an infection of the prostate can cause it to swell. This causes it to press on the urethra to block the flow of urine. A urinary tract infection (UTI) can cause swelling of the urethra to cause this problem. Diseases spread by having sex (called STDs) can also cause swelling and lead to retention.

Nerve causes. The bladder may not work right because there is a problem getting the messages from the brain to the bladder and urethra through the nerve pathway. Causes include stroke, diabetes, multiple sclerosis, trauma to the spine or pelvis, pressure on the spinal cord from tumors and a herniated disk. In women, vaginal childbirth can sometimes damage nerve pathways that control going.

If you have had a thin tube called a catheter put in you in the past, you may be at greater risk for this condition. Your risk is also higher if your doctor has used any other special device on you, such as an ureteroscope or cystoscope.

Drugs. Some types of drugs affect bladder muscle function as a side effect and can cause this problem. These include drugs called anticholinergics, the older drugs for depression, antihistamines, some blood pressure-lowering drugs, antipsychotics, hormonal agents, and muscle relaxants.

Surgery. Medicine given before and during surgery to make you sleepy may cause urinary retention right after surgery. Procedures such as hip replacement, rectal surgery, surgery for women’s issues, and surgery to remove hemorrhoids can cause the problem afterward.

What are the symptoms of urinary retention?

The signs can vary. Some people with the chronic form have a hard time starting the flow of urine. Some have a weak flow once they start. Others may feel the need to go but can’t start. Others have to go a lot, while others still feel the need to go right after going. You may “leak” urine when you aren’t going because the bladder is full.

With the acute form, you are all of a sudden not able to go at all. This occurs even though you have a full bladder. See a doctor right away if this happens to you.