Alternative names: Ischuria, Acute Urinary Retention, Chronic Urinary Retention
Urinary retention is the inability to completely empty the bladder; Acute Urinary Retention (AUR) is the (near) complete inability to pass urine, which is a medical emergency.
Chronic Urinary Retention is a long-term inability to completely empty the bladder.
Urinary retention affects men 10 times more frequently than women, and is most common in men aged over 70.
There are many possible causes of urinary retention, including:
Benign Prostatic Hyperplasia (BPH) is by far the most common cause among men.
Risk factors for urinary retention include:
The main symptoms of Acute Urinary Retention include:
In cases of Chronic Urinary Retention there are often no symptoms: the patient may not become aware of it until a secondary condition such as urinary incontinence or a urinary tract infection develops. If symptoms are present, they may include:
Tests that are commonly performed are:
The most urgent and necessary procedure is immediate and complete emptying of the bladder, normally involving catheterization. Beyond that, the underlying condition needs to be treated.
Chronic urinary retention may require surgical intervention. Types of surgery include urethral dilatation, installing urethral stents, internal urethrotomy, removal of tumors or other obstructions, prostate surgery for men, and cystocele or rectocele repair for women.
Prevention of urinary retention in men with Benign Prostatic Hyperplasia involves long-term medical treatment with 5-alpha reductase inhibitors, with or without alpha-blockers.
Diet and lifestyle changes that prevent constipation will also help to prevent urinary retention. For women with genitourinary prolapse, pelvic floor exercises can help.
Some cases of urinary retention, for example when caused by general anesthetic, resolve quickly and without long-term problems.
Other cases resolve when the underlying cause, for example BPH, has been corrected.
Sometimes the cause cannot be treated, and in such cases it is necessary, on an ongoing basis, to regularly insert a catheter into the bladder in order to void urine. This would normally be done every 3-4 hours, 4-6 times per day.
Possible post-catheterization complications include Urinary Tract Infection (UTI); acute renal failure; excess urine production, possibly resulting in electrolyte depletion; blood in the urine (this usually goes away by itself).
Acute urine retention (resulting in complete anuria – failure to produce any urine) is a medical emergency. If left untreated, the bladder can stretch to the point of tearing, and then release its contents into the abdominal cavity. Increased bladder pressure can also force urine back up the ureters into the kidneys, leading to hydronephrosis (swelling of the kidneys), pyonephrosis (kidney infection), kidney failure, chronic kidney disease due to scarring, or sepsis.
The normal capacity of the bladder is 400-600ml; the largest amount of urine drained from the bladder of a patient suffering from urinary retention was 6,000ml (6 liters).
Your body is a highly complex, interconnected system. Instead of guessing at what might be wrong, let us help you discover what is really going on inside your body based on the many clues it is giving.
Our multiple symptom checker provides in-depth health analysis by The Analyst™ with full explanations, recommendations and (optionally) doctors available for case review and answering your specific questions.