How is urinary retention treated?
Treatment for urinary retention can depend on whether you have the acute form or the chronic form, as well as the cause of the condition. For the acute form, a catheter is put into the urethra to drain the bladder.
Treatment of the chronic form – or the acute form that becomes chronic—will depend on the cause.
Medications for enlarged prostate: For men with an enlarged prostate, certain drugs may be used to try and open it up or shrink it. These include alpha-blockers (tamsulosin [Flomax®], terazosin [Hytrin®] and alfuzosin [Uroxatral®]) and 5-alpha reductase inhibitors (finasteride [Proscar®] and dutasteride [Avodart®]). Also, procedures or surgery to open up the prostate may be tried.
Procedures for enlarged prostate: Many procedures are available when this problem is due to an enlarged prostate. Office-based treatments can be done with just local anesthetic (numbing medicine) only. These include water vapor therapy (Rezum®) and prostatic urethral lift (Urolift®).
There are also several surgeries done under general anesthesia which are available. These include shaving down the inside of the prostate (transurethral resection of the prostate, or TURP) and opening up the prostate with a laser (Greenlight photoselective vaporization of the prostate, or PVP). A laser can also be used to carve out the entire enlarged portion of the prostate through the urethra (Holmium laser enucleation of the prostate, or HoLEP), or this part of the prostate can be removed through the belly (simple prostatectomy). All of these procedures can be effective in opening up the blockage.
Treatments for urethral stricture: For a urethral stricture, opening the scar tissue in the urethra with catheters and balloons may be tried. Surgery using a knife or laser that is moved through the urethra to make a cut to open the scar is also an option. Sometimes the scar tissue needs to be cut out and the urethra fixed with a surgery called a urethroplasty.
Treatment for nerve issues: If the retention is due to a nerve-related issue, you may need to use a catheter on yourself at home.
Treatments for women with urinary retention: For women with cystocele or rectocele as the cause, mild or moderate cases may be treated with exercises that strengthen the pelvic floor muscles. They also may be treated by putting in a ring called a vaginal pessary to support the bladder. Your provider may suggest estrogen therapy if you are past menopause. Surgery may be required for more severe cases to lift the sagging bladder or rectum.