August 3, 2015
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Urinary Retention (cont.)

How is urinary retention treated?

A health care provider treats urinary retention with

  • bladder drainage
  • urethral dilation
  • urethral stents
  • prostate medications
  • surgery

The type and length of treatment depend on the type and cause of urinary retention.

Bladder Drainage

Bladder drainage involves catheterization to drain urine. Treatment of acute urinary retention begins with catheterization to relieve the immediate distress of a full bladder and prevent bladder damage. A health care provider performs catheterization during an office visit or in an outpatient center or a hospital. The patient often receives local anesthesia. The health care provider can pass a catheter through the urethra into the bladder. In cases of a blocked urethra, he or she can pass a catheter directly through the lower abdomen, just above the pubic bone, directly into the bladder. In these cases, the health care provider will use anesthesia.

For chronic urinary retention, the patient may require intermittent -- occasional, or not continuous -- or long-term catheterization if other treatments do not work. Patients who need to continue intermittent catheterization will receive instruction regarding how to self-catheterize to drain urine as necessary.

Urethral Dilation

Urethral dilation treats urethral stricture by inserting increasingly wider tubes into the urethra to widen the stricture. An alternative dilation method involves inflating a small balloon at the end of a catheter inside the urethra. A health care provider performs a urethral dilation during an office visit or in an outpatient center or a hospital. The patient will receive local anesthesia. In some cases, the patient will receive sedation and regional anesthesia.

Urethral Stents

Another treatment for urethral stricture involves inserting an artificial tube, called a stent, into the urethra to the area of the stricture. Once in place, the stent expands like a spring and pushes back the surrounding tissue, widening the urethra. Stents may be temporary or permanent. A health care provider performs stent placement during an office visit or in an outpatient center or a hospital. The patient will receive local anesthesia. In some cases, the patient will receive sedation and regional anesthesia.

Prostate Medications

Medications that stop the growth of or shrink the prostate or relieve urinary retention symptoms associated with benign prostatic hyperplasia include

  • dutasteride (Avodart)
  • finasteride (Proscar)

The following medications relax the muscles of the bladder outlet and prostate to help relieve blockage:

  • alfuzosin (Uroxatral)
  • doxazosin (Cardura)
  • silodosin (Rapaflo)
  • tadalafil (Cialis)
  • tamsulosin (Flomax)
  • terazosin (Hytrin)

Surgery

Prostate surgery. To treat urinary retention caused by benign prostatic hyperplasia, a urologist -- a doctor who specializes in the urinary tract -- may surgically destroy or remove enlarged prostate tissue by using the transurethral method. For transurethral surgery, the urologist inserts a catheter or surgical instruments through the urethra to reach the prostate. Removal of the enlarged tissue usually relieves the blockage and urinary retention caused by benign prostatic hyperplasia. A urologist performs some procedures on an outpatient basis. Some men may require a hospital stay. In some cases, the urologist will remove the entire prostate using open surgery. Men will receive general anesthesia and have a longer hospital stay than for other surgical procedures. Men will also have a longer rehabilitation period for open surgery.

Internal urethrotomy. A urologist can repair a urethral stricture by performing an internal urethrotomy. For this procedure, the urologist inserts a special catheter into the urethra until it reaches the stricture. The urologist then uses a knife or laser to make an incision that opens the stricture. The urologist performs an internal urethrotomy in an outpatient center or a hospital. The patient will receive general anesthesia.

Cystocele or rectocele repair. Women may need surgery to lift a fallen bladder or rectum into its normal position. The most common procedure for cystocele and rectocele repair involves a urologist, who also specializes in the female reproductive system, making an incision in the wall of the vagina. Through the incision, the urologist looks for a defect or hole in the tissue that normally separates the vagina from the other pelvic organs. The urologist places stitches in the tissue to close up the defect and then closes the incision in the vaginal wall with more stitches, removing any extra tissue. These stitches tighten the layers of tissue that separate the organs, creating more support for the pelvic organs. A urologist or gynecologist -- a doctor who specializes in the female reproductive system -- performs the surgery to repair a cystocele or rectocele in a hospital. Women will receive anesthesia.

Tumor and cancer surgery. Removal of tumors and cancerous tissues in the bladder or urethra may reduce urethral obstruction and urinary retention.

Medically Reviewed by a Doctor on 8/13/2014

Source: MedicineNet.com
http://www.medicinenet.com/urinary_retention/article.htm

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