Urinary retention occurs when a person cannot urinate and needs to, or can only urinate a small amount but isn’t able to fully remove urine from the bladder. This condition may either be classed as chronic or acute, where in chronic conditions the person experiences this to smaller or lesser degree on a fairly constant basis. It has a variety of causes and treatment depends on cause. In a number of cases, urinary retention can be fully cured, but sometimes it can only be palliated through measures that have to be employed on a constant basis to empty the bladder.
The symptoms of urinary retention may be different depending upon whether the condition is acute or chronic. Acute retention is very serious and it means there is no way to urinate. A person simply can’t no matter how much they might try.
This form of the condition is considered extremely serious and medically urgent because continued filling of the bladder can lead to permanent damage. It may occur as a result of some damage to the bladder or structures that surround it, and sometimes that damage is temporary. For instance, a pregnant woman that has an epidural during labor frequently experiences acute retention; to address this, she might have a urine catheter to remove the urine and prevent bladder injury.
In most cases, standard treatment for acute retention is to first use a urine catheter to empty the bladder. Depending on underlying causes, this could be the only treatment, or additional treatments might be required. If damage to the bladder or the ability to urinate is impaired for a long period of time, regular catheterization could be necessary.
Employing a cath for chronic urinary retention isn’t always needed. In this condition, risk of bladder damage over time can exist too, but people are able to excrete some urine. Very frequently, underlying condition for chronic forms is enlargement of the prostate gland; this is the most common cause and is exclusive to men. Treatment might turn to shrinking the prostate gland when this is the case.
Other causes of chronic urinary retention include urinary tract infection, weakness in the bladder and vagina or pelvic floor, problems with the urethra that cause it to narrow, blockage of the urethra with bladder stones, and certain medications. It’s easy to see how different treatment might be depending on cause. A urinary tract infection could necessitate giving antibiotics, bladder stones might need to be dissolved with medication or surgically removed, and some medications like antihistamines or those used for urinary incontinence could need to be discontinued.
More invasive measures could be needed if the pelvic floor weakens enough to allow the bladder to push into the vagina, and surgery to repair the muscles is not uncommon. Some men have urethral stricture, which results in a much narrower pathway for passing urine. Balloon catheter might open this stricture or surgical measures could be required to create a better opening.
Sometimes damage to the nerves is so significant that people require regular urinary catheterization. Training on how to properly perform this under clean or sterile conditions is extremely valuable to prevent infection. Regular caths have the tendency to cause much higher risk of infection in the urinary tract, which might lead to an acute case of urinary retention.
It should also be noted that even if chronic urinary retention is less immediately urgent than acute forms, it still requires medical treatment. Inability to go some of the time or empty the bladder fully runs risk of constant infection and great damage to the bladder that could make the problem irreparable. Should this condition arise, it should be brought to the attention of a doctor right away, so cause can be diagnosed and treatment can begin.