Urinary Retention: Treatment, Procedure, Cost and Side Effects

Urinary retention has no synonyms

Urinary retention is the inability to empty the bladder completely. Urinary retention can be acute or chronic. Acute urinary retention happens suddenly and lasts only a short time. People with acute urinary retention cannot urinate at all, even though they have a full bladder. Acute urinary retention, a potentially life-threatening medical condition, requires immediate emergency treatment. Acute urinary retention can cause great discomfort or pain. Chronic urinary retention can be a long-lasting medical condition. People with chronic urinary retention can urinate. However, they do not completely empty all of the urine from their bladders.

Urinary retention can be caused by several problems, such as obstruction of the urethra, problems related to the central nervous system, medications, and weakened bladder muscles. Obstruction of the urethra causes urinary retention by blocking the normal urine flow out of the body. Conditions such as benign prostatic hyperplasia can cause an obstruction. Urinary retention can result from problems with the nerves that control the bladder and sphincters. Many events or conditions can interfere with nerve signals between the brain and the bladder and sphincters. If the nerves are damaged, the brain may not get the signal that the bladder is full. Even when a person has a full bladder, the bladder muscles that squeeze urine out may not get the signal to push, or the sphincters may not get the signal to relax. Various medications can also cause urinary retention by interfering with nerve signals to the bladder and prostate. A few of these medications include certain antihistamines, antispasmodics and certain antidepressants.

Urinary retention can be treated in a variety of ways, including bladder drainage, urethral dilation, urethral stents, prostate medications and surgery. The type and length of treatment depends on the type and cause of urinary retention.

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. The health care provider passes 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.

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.

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.

Certain medications can also be administered to stop the growth of or shrink the prostate to relieve urinary retention, and these include dutasteride and finasteride, among other medications.

The last resort for treating urinary retention is prostate surgery. To treat urinary retention caused by benign prostatic hyperplasia, a urologist may surgically destroy or remove enlarged prostate tissue by using the transurethral method. Removal of the enlarged tissue usually relieves the blockage and urinary retention caused by benign prostatic hyperplasia.

Once urinary retention has been diagnosed with the help of physical exams and medical tests such as cystoscopy, CT scans and electromyography, the doctor then decides the appropriate method of treatment for the patient, depending upon his/her type of urinary retention, and the causes behind it.

Urinary retention is different from other urinary issues, and if the problem is resolved by medications prescribed by the urologist, then no further specialized treatment is necessary.

Treating urinary retention can often have some side effects, such as urinary tract infections, bladder damage, kidney damage, and urinary incontinence, especially after surgery.

Urine is normally sterile, and the normal flow of urine usually prevents bacteria from infecting the urinary tract. With urinary retention, the abnormal urine flow gives bacteria at the opening of the urethra a chance to infect the urinary tract. Also, If the bladder becomes stretched too far or for long periods, the muscles may be permanently damaged and lose their ability to contract. Additionally, in some people, urinary retention causes urine to flow backward into the kidneys. This backward flow, called reflux, may damage or scar the kidneys.

Since urinary retention is treated using various different methods, each method has separate post-treatment guidelines. In case of bladder drainage and urethral dilation, post-operative treatment generally includes the patient being instructed on how to self-catheterize to drain urine as necessary. For treatment via prostate surgery, the patient has to stay in hospital for a couple of weeks. For the first week the patient urinates via the catheter, following which he can urinate on his own. Physical activities requiring wide range of motion are prohibited for up to a few months after the surgery.

Depending on the type of treatment, recovery can take anywhere between two days to several months. In case of prostate surgery, full recovery can take up to 6 months.

Depending on the type of treatment, the price can range from Rs. 10,000 to Rs. 8,00,000

In case of acute urinary retention, a single drainage of the bladder is able to successfully treat urinary retention. However, in case of chronic urinary retention, the patient has to keep coming back to have their bladder drained, in which case the treatment is a chronic one. If prostate surgery is involved, then the results are always permanent.