What are the signs of urinary retention?
The signs can vary depending on if you have acute or chronic urinary retention.
Acute urinary retention symptoms
With the acute form, symptoms come on more suddenly. You may not be able to pee at all, or only be able to go very small amounts even though you have a full bladder. In severe cases, it can cause digestive discomfort and lower abdominal pain. See a healthcare provider right away if this happens to you.
Chronic urinary retention symptoms
Symptoms of chronic urinary retention can vary from one person to another. Some symptoms include:
- Difficulty starting to pee.
- Weak, slow or uncontrollable urine stream.
- Feeling the need to pee immediately after you’ve just peed.
- Feeling like you always need to pee.
- Leaking pee.
- Waking up several times at night to pee (nocturia).
What causes urinary retention?
Urinary retention can happen for several different reasons. These causes can include:
- A blockage to the way urine leaves your body.
- Medications you’re taking for other conditions.
- Nerve issues that interrupt the way your brain and urinary system communicate.
- Infections or swelling that prevent pee from leaving your body.
- Surgery.
Blockage
When something blocks the free flow of urine through your bladder and urethra, you might experience urinary retention. Blockages (obstructions) are one of the most common causes of urinary retention.
Some reasons you may experience a blockage include:
- Enlarged prostate: In people AMAB, a blockage can happen when their prostate gland gets so big that it presses on their urethra.
- Bladder outlet obstruction: These obstructions affect the neck of your bladder, which is the area just before your pee leaves your body.
- Ureteral obstruction: Ureteral stones, blood clots, tumors or other factors can lead to a blockage in your urethra.
- Cystocele: This is a condition where your bladder can sag into your vagina.
- Rectocele: This is a condition in which your rectum sags into your vaginal wall.
- Urethral stricture: Your urethra narrows due to scar tissue.
Medications
Certain medications can cause urinary retention. Drugs like antihistamines (Benadryl®), antispasmodics (like Detrol®), opiates (like Vicodin®) and tricyclic antidepressants (like Elavil®) can change the way your bladder muscle works.
Other medications that may cause bladder control side effects are:
- Some blood pressure-lowering medications.
- Antipsychotics.
- Muscle relaxants.
Nerve issues
You may not know this, but your brain plays a role in urination. Passing urine happens when your brain tells your bladder muscle to tighten to squeeze your pee out. Your brain then tells your sphincter muscles surrounding your urethra to relax. This lets the flow of urine go out of your body. If there’s an issue in how your brain talks to your nerves, it can cause a problem with urination.
Causes of nerve issues can include:
- Stroke.
- Diabetes.
- Multiple sclerosis (MS).
- Trauma to your spine or pelvis due to an accident or injury.
- Pressure on the spinal cord from tumors and a herniated disk.
- Vaginal childbirth.
- Some types of pelvic surgery.
You’re also at a higher risk of nerve issues if you’ve had a catheter (thin tube that removes pee directly from your bladder).
Infection or swelling
Infection and swelling (inflammation) can also affect how pee flows through your urethra. Some examples of urinary retention due to infection or inflammation are:
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- Prostatitis: Infection or inflammation in your prostate causes it to swell and press up against your urethra, blocking the flow of pee.
- Urinary tract infection (UTI): An infection in your urinary tract can cause your urethra to swell or cause weakness in your bladder, both of which can cause urinary retention.
- Sexually transmitted infections (STIs): Infections spread through sexual contact can also cause swelling and lead to urinary retention.
Surgery
You may experience urinary retention after having joint replacement surgery (such as hip replacement) or spinal surgery. Having general anesthesia during a procedure can also cause temporary urinary retention.
What are the risk factors for urinary retention?
Anyone can have urinary retention, but it occurs more often in people AMAB. People with an enlarged prostate (benign prostatic hyperplasia or BPH) are most likely to develop urinary retention because their prostates push on their urethras, blocking the flow of urine out of their bladder.
What are the complications of urinary retention?
Left undiagnosed or untreated, urinary retention can lead to:
- UTIs: Pee that stays in your bladder is a breeding ground for bacteria. This can cause infection in your urinary tract that can spread up to your kidneys.
- Bladder damage: When pee stays in your bladder, it can overstretch your bladder muscles and damage them.
- Kidney damage: An infection in your urinary tract can spread up to your kidneys, causing them to inflame and swell. This pressure can damage your kidneys and lead to kidney disease.
- Leaking pee: When your bladder doesn’t fully drain, it can lead to you accidentally leaking pee.
- Bladder stones: When pee stays in your bladder, it could lead to bladder stones.
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