What is it about ?
We speak of urinary retention when it is impossible to urinate while the bladder is full: the urine remains in the bladder. This phenomenon can occur suddenly (acute form) or evolve more slowly (chronic form).
There are many causes that can explain urinary retention:
- side effects of drugs that affect the nervous system;
- benign swelling of the prostate (benign prostatic hyperplasia) (in men);
- a prolapse (or descent) of the uterus, bladder or rectum (in women);
- a reaction after an operation (post-operative reaction);
- narrowing of the urethra, for example after an operation or infection;
- problems with the nervous system, such as hernia, a spinal cord injury or the MS (multiple sclerosis) ;
- exposure to cold;
- the alcohol ;
- pain or tension.
What is its frequency?
We do not know the exact figures. Urinary retention is more common in men than in women, due to the many cases ofprostatic hyperplasia.
How to recognize it?
Acute urinary retention
In case of acute urinary retention, we suddenly no longer manage to urinate and we feel strong pain in the lower abdomen. Sometimes you can feel a lump in your stomach.
Chronic urinary retention
In case of chronic urinary retention, the bladder fills slowly, and the patient often has difficulty emptying the bladder. There is often less urine, but the pain is still manageable. In doing so, the bladder can fill up so much that it overflows. In this case, urine is evacuated but without emptying the bladder (overflow incontinence).
How is the diagnosis made?
The doctor can usually make the diagnosis based on the symptoms observed. He can also feel the stomach to feel if the bladder has increased in size. An ultrasound can show how much urine is in the bladder.
If there is a triggering factor, no further examination is required at the first episode of urinary retention.
The doctor takes a urine sample to check for the presence of urinary tract infection. If a specific cause for the problem cannot be found, specific examinations may be required.
What can you do ?
See an emergency doctor if you are unable to urinate, as treatment will need to be started as soon as possible.
In the event of chronic urinary retention, additional examinations are required. The doctor will look for the cause and determine a possible treatment to follow.
What can your doctor do?
You may need to make a urinary catheterization (only once). In this case, a flexible tube is inserted through the urethra into the bladder to be able to empty it. We sometimes use a indwelling catheter. It is a flexible tube that can be left in place for several days.
It happens that we place a probe by making a tiny incision above the pubis. This technique is used if:
- large volumes (> 1 liter) must be evacuated;
- the urethra has narrowed;
- the prostate has enlarged, and probing via the urethra does not work, or is very difficult;
- urinary retention manifests itself recurrently.
This catheter is removed when you can urinate normally again and there is not too much urine in the bladder after urinating.
Further processing
Further treatment depends on the cause of urinary retention.
- People who cannot pass urine after an operation can be treated with medicines that relax the muscle cells at the junction between the bladder and the urethra (bladder neck).
- In the event of chronic urinary retention due to an enlarged prostate, drug treatment is also prescribed, but surgery may also be necessary in the long term.
- Medicines that cause urinary retention can be stopped.
- A stricture of the urethra can be resolved with a small instrument that allows you to look inside the urethra, or with an operation.
Want to know more?
- Advice to the patient with a bladder catheter, here, Where to find on this page of Cliniques St Luc UCL
- Advice to the patient with a bladder catheter, here, Where to find on this page of Cliniques St Luc UCL
- Advice to the patient with a suprapubic drain, here, Where to find on this page of Cliniques St Luc UCL
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