Urinary retention
From Wikipedia, the free encyclopedia
Urinary retention also known as ischuria is a lack of ability to urinate. It is a common complication of benign prostatic hypertrophy (also known as benign prostatic hyperplasia or BPH), although anticholinergics may also play a role, and requires a catheter. Various medications (e.g. some antidepressants) and recreational use of amphetamines are notorious for this.
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[edit] Signs and Symptoms
Urinary retention is characterised by poor urinary stream with intermittance, straining, a sense of incomplete voiding and urgency. As the bladder remains full, it may lead to incontinence, nocturia (need to urinate at night) and high frequency. Retention is a medical emergency, as the bladder may "distend" (stretch) to enormous sizes and posibly tear if not dealt with quickly. As the bladder "distends" it may become painful. You should go straight to your emergency department as soon as possible if you are unable to urinate and you have an extremely full bladder. The water can also pass back up the ureters and get into the kidneys, causing damage or failure to the kidneys.
In the longer term, obstruction of the urinary tract may cause:
- Bladder stones
- Loss of detrusor muscle tone (atonic bladder is an extreme form)
- Hydronephrosis (congestion of the kidneys)
- Hypertrophy of detrusor muscle
- Diverticula in the bladder wall (leads to stones and infection)
[edit] Causes
- Benign prostatic hypertrophy
- Prostate cancer and other pelvic malignancies
- Congenital urtheral valve abnormalities
- Detrusor muscle dyssynergia
- Circumcision
- Damage to the Bladder
[edit] Diagnostic tests
Uroflowmetry may aid in establishing the type of micturition abnormality. A post-void residual scan may show the amount of urine retained. Determination of the serum prostate-specific antigen (PSA) may aid in diagnosing or ruling out prostate cancer. Urea and creatinine determinations may be necessary to rule out backflow kidney damage.
[edit] Treatment
In acute urinary retention, urinary catheterization or suprapubic cystostomy instantly relieves the retention. In the longer term, treatment depends on the cause. Benign prostatic hypertrophy may respond to alpha blocker and 5-alpha-reductase inhibitor therapy, or surgically with prostatectomy or transurethral resection of the prostate (TURP).
[edit] How you can help yourself if you are in Urinary Retention
- Run a tap when trying to urinate
- Try a hot bath, it may help you urinate, it may help if you are in water and may give you the urge to go
- Use a intermittent catheter if you have one ready to hand, to drain the bladder of the fluid in it.
- Reduce your fluid input if you are in retention, to avoid further distention of the bladder.
