Urinary retention

What is urinary retention?

Urinary retention occurs when you are not able to completely empty your bladder. It can be:

• acute — if your bladder feels full but you can’t pass any urine
• chronic — if you can pass urine, but your bladder is still partially full when you finish

Urinary retention needs to be treated. If not, it can cause kidney or bladder damage.

What are the symptoms of acute urinary retention?

Acute urinary retention usually comes on suddenly. Symptoms include:

• severe lower abdominal pain (but you may not have much pain if you already have chronic urinary retention)
• a feeling of fullness in your lower abdomen
• wanting to pass urine but not being able to

Acute urinary retention needs urgent medical attention. A doctor or nurse will empty your bladder using a urinary catheter, which is a long soft tube inserted into your urethra.

What are the symptoms of chronic urinary retention?

Chronic urinary retention comes on more gradually. It may take a long time for you to notice symptoms.

Symptoms may include:

• straining to pass urine or a weaker flow of urine with a slow start
• feeling like your bladder is still full after you pass urine
• overflow incontinence — leaking urine without being able to control it
• difficulty holding in your urine, especially when you cough or sneeze
• wetting yourself or needing to urinate frequently at night
• swelling and mild pain in your abdomen

How is urinary retention caused?

There are many reasons why you might develop urinary retention. It is more likely as you get older, because of changes in your urinary tract that occur with ageing.

If something blocks or presses on your urethra (the passage that lets urine out of your bladder) it can cause urinary retention. A blockage can be caused by:

• a full bladder
• an enlarged prostate gland (in males)
• constipation
• urinary tract stones
• tumours
• vaginal prolapse (in females)
• narrowing of your urethra (more common in males)

Damage to the nerves that control your bladder muscle can cause urinary retention. Damage may be caused by:

• spinal injuries
• health conditions affecting your nervous system, such as diabetes, multiple sclerosis, stroke or Parkinson’s disease

Other causes of urinary retention include:

• recent surgery pain or mobility problems
• some medicines
• a urinary tract infection
• recently giving birth

Complications of urinary retention

If you have urinary retention you may get:

• urinary tract infections
• kidney infections
• stones in your kidneys and bladder

When urine builds up in your bladder, it can cause pressure and overstretching throughout your urinary tract. This can go all the way up to your kidneys. It can lead to:

• damage to your bladder
• a tear in the wall of your bladder
• damage to your kidneys

How is urinary retention diagnosed?

You may have a bladder scan. This test uses ultrasound to measure the amount of urine in your bladder. If you are able to pass urine, a bladder scan can measure how much urine is left in your bladder after you urinate.

Your doctor may also examine you and order tests to look for the cause of your urinary retention.

How is urinary retention treated?

If you have acute urinary retention, your bladder will be emptied with a catheter. The catheter may need to stay in place for a while. You may need to learn to use a catheter yourself to empty your bladder on a regular basis.

Treatment depends on what is causing your urinary retention. It may include:

• changing your medicines
• pain relief
• antibiotics
• treating constipation
• referral to a urologist or urogynaecologist
• medicines for prostate enlargement
• surgery

If urinary incontinence is a problem for you, your doctor or continence nurse can give you advice about how to manage it.

When should I see a doctor?

See your doctor if you have:

• symptoms of urinary retention
• symptoms of a urinary tract infection
• blood in your urine
• symptoms that don’t improve with treatment

If you have a catheter, see your doctor immediately or go to the emergency department if:

• you feel unwell
• you have a fever
• you have pain in your abdomen or around the catheter
• your urine has a bad smell or contains blood
• no urine has drained for 4 hours

What can I do to help myself pass urine?

If you are having trouble passing urine, there are some things you can do that may help you urinate:

• Try urinating in a warm shower or bath.
• Put your hand in cold water.
• See a doctor or continence nurse for advice about when and how to sit on the toilet.

If you think you cannot urinate because of your medicines, talk to your doctor about it. You shouldn’t stop taking your medicines until you have been advised it is safe to do so.