Unable to Urinate

Some people are unable to urinate and this can be a concerning underlying medical condition which is technically called as Urinary Retention. This is basically inability of a person to pass urine and empty the bladder. In chronic cases of urinary retention, affected individual often face difficulty starting urine stream to vacant the bladder completely. However, under such circumstances the urge to urinate is normal or intense but the patient is unable to pass urine.

Sometimes there is little excretion of urine but even after that the person feels to urinate. In case of acute urine retention issue the person cannot pass urine at all, despite of having filled bladder.  If a person is affected with acute form of the condition then prompt medical assistance may be needed as it is categorized to be a medical emergency. On the other hand chronic urine retention is not a life threatening issue but may lead to serious complications and thus should be treated timely.

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Urine retention issue can affect almost anyone, but it is common in men between the age group of 50 and 60 years. This is because these men may have enlarged prostrate. Women may also suffer from the issue if they are already affected with cystocele.

Causes of urine retention

There are several factors that may lead to such issues. For example, urinary tract obstruction can make a person unable to urinate. Nerve associated issues that hinder the signals between bladder and the brain may also contribute to cause urine retention issue. If signals are affected then the body will not be able to squeeze relevant muscles that expel the urine out of the bladder. There are several other factors that may lead to such physical anomalies. Some of these are:

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  • Spinal cord injury or nerve disease caused due to vaginal childbirth, spinal cord or brain infection, stroke, diabetes mellitus, multiple sclerosis, pelvic injuries, etc.
  • Enlarged prostate or benign prostatic hyperplasia which can thicken the bladder walls which eventually weakens the bladder and it becomes malfunction with deprived capability to empty itself.
  • Irritation and swelling caused due to infections such as Urinary Tract Infection may cause urinary retention problem
  • Surgical procedure may also sometimes contribute to cause such issue
  • There are certain medicines which may cause urinary retention such as fexofenadine, chlorpheniramine, cetirizine, oxybutynin, propanteline, imipramine, nortriptyline, doxepin etc.
  •  Bladder stone development in any region of urinary tract may lead to obstruction of the bladder preventing urine from ejaculating.
  • Rectocele and Crystocele are two conditions that may aggravate to cause difficulties while urinating.
  • Harder stool in rectum may exert pressure on urethra making it blocked causing urinary difficulties

Symptoms of Urinary retention

Inability to urinate is the chief characteristic of urinary retention issue. The condition is also characterized with improper urine flow, straining while urinating and sense of incomplete urination. There is often a delay between exertion of pressure while trying to urinate and actual flow of urine. Even after urinating the affected individual may feel the bladder is filled. Sometimes the issue can result in nocturia, a condition wherein a person may want to urinate at night with increased frequency. Acute urinary retention can lead to complete anuria, which is a serious medical condition as the bladder can enormously stretch and may also tear-off if not addressed. Some other symptoms of the condition include:

  • Lower abdomen Pain and discomfort
  • Though your bladder feels full urinating becomes difficult
  • Bloated lower stomach
  • Frequent urination
  • A sensation that you have to still urinate after vesting lavatory few minutes back
  • Urine stream the starts and stops on its own (no control on urine flow)

Diagnosis

There are several tests that are suggested to patients suffering from urinary retention. However, foremost the doctor will analyze associated symptoms and will also physically examine the lower abdomen. The doctor may feel dilated bladder by percussing the lower belly. He may also suggest urine test where urine should be collected as sample to be sent to laboratory for testing. Bladder scan is done using a portable ultrasound machine that can help in determining the amount of urine in your bladder.  In this test the patient is asked to urinate and an expert will test the urine for PVR (Post Void Residual). ‘Residual’ refers to amount of urine remaining in the bladder post urination. There are also other tests suggested to determine the affliction of the condition, which may include CT scan, X-rays, blood test for PSA, Prostate Fluid Sample and Urodynamic Tests, etc.

Urinary Retention treatment

The treatment is best suggested by the doctor. Urinary retention treatment starts with catheter insertion through urethra empty the bladder. This catheter will be used to relieve from immediate distress. It will help in preventing permanent damages to the bladder. Doctor may also suggest treatment to relieve swelling of prostate. If any woman is suffering from urinary retention associated with cystocele or rectocele, doctor may recommend surgery.

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