Coping with... CHRONIC URINARY RETENTION

Chronic urinary retention is the inability to completely empty the bladder

- Dr Gill Jenkins

In chronic retention, the bladder still functions, but you’re unable to fully empty your bladder. There may be no pain, but associated symptoms include a feeling of incomplete emptying, poor stream, urinary frequency and urgency, or difficulty passing urine. Some aren’t aware they can’t empty their bladder fully until incontinence or a urinary infection occur. You should see a doctor immediately if you have acute retention and are unable to pass any urine when your bladder feels full and painful.

High-pressure chronic urinary retention is similar, but the bladder is tense and kidney impairment occurs due to back pressure, which needs urgent drainage.

Urinary retention is more common in men than women, and with ageing, affecting one in 100 men in their 70s, and three in 100 in their 80s.

The causes in men include benign prostatic enlargement, prostate cancer, urethral strictures, infections, constipation, surgery, antidepressants, decongestants, and muscle relaxants – including bladder relaxants used to treat an overactive bladder or incontinence. In women, it can occur following pelvic prolapse, pelvic masses, constipation or with medications as for men. Tests will be needed; the treatment and outcome then depend on that.

Treatment

The GP will take a history and examine you for swellings in the abdomen, plus a genital and rectal examination for prolapse or for enlarged prostate in men. If needed, they’ll put in a urinary catheter and measure the residual volume, test your urine for infection, and do blood tests including kidney function.