Urinary Retention (cont.)
In this Article
- Urinary retention facts*
- What is urinary retention?
- What is the urinary tract and how does it work?
- What causes urinary retention?
- How common is urinary retention?
- What are the symptoms of urinary retention?
- When should people seek medical care for urinary retention?
- How is urinary retention diagnosed?
- How is urinary retention treated?
- What are the complications of urinary retention and its treatments?
- How can urinary retention be prevented?
- Does diet affect urinary retention?
- What are points to remember about urinary retention?
- What research is being done on urinary retention?
- Where can people find more information on urinary retention?
- Find a local Urologist in your town
How common is urinary retention?
Urinary retention in men becomes more common with age.
- In men 40 to 83 years old, the overall incidence of urinary retention is 4.5 to 6.8 per 1,000 men.
- For men in their 70s, the overall incidence increases to 100 per 1,000 men.
- For men in their 80s, the incidence of acute urinary retention is 300 per 1,000 men.
Urinary retention in women is less common, though not rare. The incidence of urinary retention in women has not been well studied because researchers have primarily thought of urinary retention as a man's problem related to the prostate.
What are the symptoms of urinary retention?
The symptoms of acute urinary retention may include the following and require immediate medical attention:
- inability to urinate
- painful, urgent need to urinate
- pain or discomfort in the lower abdomen
- bloating of the lower abdomen
The symptoms of chronic urinary retention may include
- urinary frequency -- urination eight or more times a day
- trouble beginning a urine stream
- a weak or an interrupted urine stream
- an urgent need to urinate with little success when trying to urinate
- feeling the need to urinate after finishing urination
- mild and constant discomfort in the lower abdomen and urinary tract
Some people with chronic urinary retention may not have symptoms that lead them to seek medical care. People who are unaware they have chronic urinary retention may have a higher chance of developing complications.
When to Seek Medical Care
A person who has any of the following symptoms should see a health care provider right away:
- complete inability to urinate
- great discomfort or pain in the lower abdomen and urinary tract
How is urinary retention diagnosed?
A health care provider diagnoses acute or chronic urinary retention with
- a physical exam
- postvoid residual measurement
A health care provider may use the following medical tests to help determine the cause of urinary retention:
- computerized tomography (CT) scans
- urodynamic tests
A health care provider may suspect urinary retention because of a patient's symptoms and, therefore, perform a physical exam of the lower abdomen. The health care provider may be able to feel a distended bladder by lightly tapping on the lower belly.
Postvoid Residual Measurement
This test measures the amount of urine left in the bladder after urination. The remaining urine is called the postvoid residual. A specially trained technician performs an ultrasound, which uses harmless sound waves to create a picture of the bladder, to measure the postvoid residual. The technician performs the bladder ultrasound in a health care provider's office, a radiology center, or a hospital, and a radiologist -- a doctor who specializes in medical imaging -- interprets the images. The patient does not need anesthesia.
A health care provider may use a catheter -- a thin, flexible tube -- to measure postvoid residual. The health care provider inserts the catheter through the urethra into the bladder, a procedure called catheterization, to drain and measure the amount of remaining urine. A postvoid residual of 100 mL or more indicates the bladder does not empty completely. A health care provider performs this test during an office visit. The patient often receives local anesthesia.
Cystoscopy. Cystoscopy is a procedure that requires a tubelike instrument, called a cystoscope, to look inside the urethra and bladder. A health care provider performs cystoscopy during an office visit or in an outpatient center or a hospital. The patient will receive local anesthesia. However, in some cases, the patient may receive sedation and regional or general anesthesia. A health care provider may use cystoscopy to diagnose urethral stricture or look for a bladder stone blocking the opening of the urethra.
CT scans. CT scans use a combination of x rays and computer technology to create images. For a CT scan, a health care provider may give the patient a solution to drink and an injection of a special dye, called contrast medium. CT scans require the patient to lie on a table that slides into a tunnel-shaped device where a technician takes the x rays. An x-ray technician performs the procedure in an outpatient center or a hospital, and a radiologist interprets the images. The patient does not need anesthesia. A health care provider may give infants and children a sedative to help them fall asleep for the test. CT scans can show
- urinary tract stones
- traumatic injuries
- abnormal, fluid-containing sacs called cysts
Urodynamic tests. Urodynamic tests include a variety of procedures that look at how well the bladder and urethra store and release urine. A health care provider may use one or more urodynamic tests to diagnose urinary retention. The health care provider will perform these tests during an office visit. For tests that use a catheter, the patient often receives local anesthesia.
- Uroflowmetry. Uroflowmetry measures urine speed and volume. Special equipment automatically measures the amount of urine and the flow rate -- how fast urine comes out. Uroflowmetry equipment includes a device for catching and measuring urine and a computer to record the data. The equipment creates a graph that shows changes in flow rate from second to second so the health care provider can see the highest flow rate and how many seconds it takes to get there. A weak bladder muscle or blocked urine flow will yield an abnormal test result.
- Pressure flow study. A pressure flow study measures the bladder pressure required to urinate and the flow rate a given pressure generates. A health care provider places a catheter with a manometer into the bladder. The manometer measures bladder pressure and flow rate as the bladder empties. A pressure flow study helps diagnose bladder outlet obstruction.
- Video urodynamics. This test uses x rays or ultrasound to create real-time images of the bladder and urethra during the filling or emptying of the bladder. For x rays, a health care provider passes a catheter through the urethra into the bladder. He or she fills the bladder with contrast medium, which is visible on the video images. Video urodynamic images can show the size and shape of the urinary tract, the flow of urine, and causes of urinary retention, such as bladder neck obstruction.
Electromyography. Electromyography uses special sensors to measure the electrical activity of the muscles and nerves in and around the bladder and sphincters. A specially trained technician places sensors on the skin near the urethra and rectum or on a urethral or rectal catheter. The sensors record, on a machine, muscle and nerve activity. The patterns of the nerve impulses show whether the messages sent to the bladder and sphincters coordinate correctly. A technician performs electromyography in a health care provider's office, an outpatient center, or a hospital. The patient does not need anesthesia if the technician uses sensors placed on the skin. The patient will receive local anesthesia if the technician uses sensors placed on a urethral or rectal catheter.
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