Question: What is (are) Urinary Retention ?
Answer: The urinary tract is the bodys drainage system for removing urine, which is composed of wastes and extra fluid. In order for normal urination to occur, all body parts in the urinary tract need to work together in the correct order. Kidneys. The kidneys are two bean-shaped organs, each about the size of a fist. They are located just below the rib cage, one on each side of the spine. Every day, the kidneys filter about 120 to 150 quarts of blood to produce about 1 to 2 quarts of urine. The kidneys work around the clock; a person does not control what they do. Ureters. Ureters are the thin tubes of muscleone on each side of the bladderthat carry urine from each of the kidneys to the bladder. Bladder. The bladder, located in the pelvis between the pelvic bones, is a hollow, muscular, balloon-shaped organ that expands as it fills with urine. Although a person does not control kidney function, a person does control when the bladder empties. Bladder emptying is known as urination. The bladder stores urine until the person finds an appropriate time and place to urinate. A normal bladder acts like a reservoir and can hold 1.5 to 2 cups of urine. How often a person needs to urinate depends on how quickly the kidneys produce the urine that fills the bladder. The muscles of the bladder wall remain relaxed while the bladder fills with urine. As the bladder fills to capacity, signals sent to the brain tell a person to find a toilet soon. During urination, the bladder empties through the urethra, located at the bottom of the bladder. Three sets of muscles work together like a dam, keeping urine in the bladder. The first set is the muscles of the urethra itself. The area where the urethra joins the bladder is the bladder neck. The bladder neck, composed of the second set of muscles known as the internal sphincter, helps urine stay in the bladder. The third set of muscles is the pelvic floor muscles, also referred to as the external sphincter, which surround and support the urethra. To urinate, the brain signals the muscular bladder wall to tighten, squeezing urine out of the bladder. At the same time, the brain signals the sphincters to relax. As the sphincters relax, urine exits the bladder through the urethra.
Source: NIDDK

Question: How many people are affected by Urinary Retention ?
Answer: Urinary retention in men becomes more common with age. - In men 40 to 83 years old, the overall incidence of urinary retention is 4.5 to 6.8 per 1,000 men.2 - For men in their 70s, the overall incidence increases to 100 per 1,000 men.2 - For men in their 80s, the incidence of acute urinary retention is 300 per 1,000 men.2 Urinary retention in women is less common, though not rare.3 The incidence of urinary retention in women has not been well studied because researchers have primarily thought of urinary retention as a mans problem related to the prostate.4
Source: NIDDK

Question: What are the symptoms of Urinary Retention ?
Answer: The symptoms of acute urinary retention may include the following and require immediate medical attention: - inability to urinate - painful, urgent need to urinate - pain or discomfort in the lower abdomen - bloating of the lower abdomen The symptoms of chronic urinary retention may include - urinary frequencyurination eight or more times a day - trouble beginning a urine stream - a weak or an interrupted urine stream - an urgent need to urinate with little success when trying to urinate - feeling the need to urinate after finishing urination - mild and constant discomfort in the lower abdomen and urinary tract Some people with chronic urinary retention may not have symptoms that lead them to seek medical care. People who are unaware they have chronic urinary retention may have a higher chance of developing complications. When to Seek Medical Care A person who has any of the following symptoms should see a health care provider right away: - complete inability to urinate - great discomfort or pain in the lower abdomen and urinary tract
Source: NIDDK

Question: How to diagnose Urinary Retention ?
Answer: A health care provider diagnoses acute or chronic urinary retention with - a physical exam - postvoid residual measurement A health care provider may use the following medical tests to help determine the cause of urinary retention: - cystoscopy - computerized tomography (CT) scans - urodynamic tests - electromyography Physical Exam A health care provider may suspect urinary retention because of a patients symptoms and, therefore, perform a physical exam of the lower abdomen. The health care provider may be able to feel a distended bladder by lightly tapping on the lower belly. Postvoid Residual Measurement This test measures the amount of urine left in the bladder after urination. The remaining urine is called the postvoid residual. A specially trained technician performs an ultrasound, which uses harmless sound waves to create a picture of the bladder, to measure the postvoid residual. The technician performs the bladder ultrasound in a health care providers office, a radiology center, or a hospital, and a radiologista doctor who specializes in medical imaginginterprets the images. The patient does not need anesthesia. A health care provider may use a cathetera thin, flexible tubeto measure postvoid residual. The health care provider inserts the catheter through the urethra into the bladder, a procedure called catheterization, to drain and measure the amount of remaining urine. A postvoid residual of 100 mL or more indicates the bladder does not empty completely. A health care provider performs this test during an office visit. The patient often receives local anesthesia. Medical Tests Cystoscopy. Cystoscopy is a procedure that requires a tubelike instrument, called a cystoscope, to look inside the urethra and bladder. A health care provider performs cystoscopy during an office visit or in an outpatient center or a hospital. The patient will receive local anesthesia. However, in some cases, the patient may receive sedation and regional or general anesthesia. A health care provider may use cystoscopy to diagnose urethral stricture or look for a bladder stone blocking the opening of the urethra. More information is provided in the NIDDK health topic, Cystoscopy and Ureteroscopy. CT scans. CT scans use a combination of x rays and computer technology to create images. For a CT scan, a health care provider may give the patient a solution to drink and an injection of a special dye, called contrast medium. CT scans require the patient to lie on a table that slides into a tunnel-shaped device where a technician takes the x rays. An x-ray technician performs the procedure in an outpatient center or a hospital, and a radiologist interprets the images. The patient does not need anesthesia. A health care provider may give infants and children a sedative to help them fall asleep for the test. CT scans can show - urinary tract stones - UTIs - tumors - traumatic injuries - abnormal, fluid-containing sacs called cysts Urodynamic tests. Urodynamic tests include a variety of procedures that look at how well the bladder and urethra store and release urine. A health care provider may use one or more urodynamic tests to diagnose urinary retention. The health care provider will perform these tests during an office visit. For tests that use a catheter, the patient often receives local anesthesia. - Uroflowmetry. Uroflowmetry measures urine speed and volume. Special equipment automatically measures the amount of urine and the flow ratehow fast urine comes out. Uroflowmetry equipment includes a device for catching and measuring urine and a computer to record the data. The equipment creates a graph that shows changes in flow rate from second to second so the health care provider can see the highest flow rate and how many seconds it takes to get there. A weak bladder muscle or blocked urine flow will yield an abnormal test result. - Pressure flow study. A pressure flow study measures the bladder pressure required to urinate and the flow rate a given pressure generates. A health care provider places a catheter with a manometer into the bladder. The manometer measures bladder pressure and flow rate as the bladder empties. A pressure flow study helps diagnose bladder outlet obstruction. - Video urodynamics. This test uses x rays or ultrasound to create real-time images of the bladder and urethra during the filling or emptying of the bladder. For x rays, a health care provider passes a catheter through the urethra into the bladder. He or she fills the bladder with contrast medium, which is visible on the video images. Video urodynamic images can show the size and shape of the urinary tract, the flow of urine, and causes of urinary retention, such as bladder neck obstruction. More information is provided in the NIDDK health topic, Urodynamic Testing. Electromyography. Electromyography uses special sensors to measure the electrical activity of the muscles and nerves in and around the bladder and sphincters. A specially trained technician places sensors on the skin near the urethra and rectum or on a urethral or rectal catheter. The sensors record, on a machine, muscle and nerve activity. The patterns of the nerve impulses show whether the messages sent to the bladder and sphincters coordinate correctly. A technician performs electromyography in a health care providers office, an outpatient center, or a hospital. The patient does not need anesthesia if the technician uses sensors placed on the skin. The patient will receive local anesthesia if the technician uses sensors placed on a urethral or rectal catheter.
Source: NIDDK

Question: What are the treatments for Urinary Retention ?
Answer: A health care provider treats urinary retention with - bladder drainage - urethral dilation - urethral stents - prostate medications - surgery The type and length of treatment depend on the type and cause of urinary retention. Bladder Drainage Bladder drainage involves catheterization to drain urine. Treatment of acute urinary retention begins with catheterization to relieve the immediate distress of a full bladder and prevent bladder damage. A health care provider performs catheterization during an office visit or in an outpatient center or a hospital. The patient often receives local anesthesia. The health care provider can pass a catheter through the urethra into the bladder. In cases of a blocked urethra, he or she can pass a catheter directly through the lower abdomen, just above the pubic bone, directly into the bladder. In these cases, the health care provider will use anesthesia. For chronic urinary retention, the patient may require intermittentoccasional, or not continuousor long-term catheterization if other treatments do not work. Patients who need to continue intermittent catheterization will receive instruction regarding how to selfcatheterize to drain urine as necessary. Urethral Dilation Urethral dilation treats urethral stricture by inserting increasingly wider tubes into the urethra to widen the stricture. An alternative dilation method involves inflating a small balloon at the end of a catheter inside the urethra. A health care provider performs a urethral dilation during an office visit or in an outpatient center or a hospital. The patient will receive local anesthesia. In some cases, the patient will receive sedation and regional anesthesia. Urethral Stents Another treatment for urethral stricture involves inserting an artificial tube, called a stent, into the urethra to the area of the stricture. Once in place, the stent expands like a spring and pushes back the surrounding tissue, widening the urethra. Stents may be temporary or permanent. A health care provider performs stent placement during an office visit or in an outpatient center or a hospital. The patient will receive local anesthesia. In some cases, the patient will receive sedation and regional anesthesia. Prostate Medications Medications that stop the growth of or shrink the prostate or relieve urinary retention symptoms associated with benign prostatic hyperplasia include - dutasteride (Avodart) - finasteride (Proscar) The following medications relax the muscles of the bladder outlet and prostate to help relieve blockage: - alfuzosin (Uroxatral) - doxazosin (Cardura) - silodosin (Rapaflo) - tadalafil (Cialis) - tamsulosin (Flomax) - terazosin (Hytrin) Surgery Prostate surgery. To treat urinary retention caused by benign prostatic hyperplasia, a urologista doctor who specializes in the urinary tractmay surgically destroy or remove enlarged prostate tissue by using the transurethral method. For transurethral surgery, the urologist inserts a catheter or surgical instruments through the urethra to reach the prostate. Removal of the enlarged tissue usually relieves the blockage and urinary retention caused by benign prostatic hyperplasia. A urologist performs some procedures on an outpatient basis. Some men may require a hospital stay. In some cases, the urologist will remove the entire prostate using open surgery. Men will receive general anesthesia and have a longer hospital stay than for other surgical procedures. Men will also have a longer rehabilitation period for open surgery. More information is provided in the NIDDK health topic, Prostate Enlargement: Benign Prostatic Hyperplasia. Internal urethrotomy. A urologist can repair a urethral stricture by performing an internal urethrotomy. For this procedure, the urologist inserts a special catheter into the urethra until it reaches the stricture. The urologist then uses a knife or laser to make an incision that opens the stricture. The urologist performs an internal urethrotomy in an outpatient center or a hospital. The patient will receive general anesthesia. Cystocele or rectocele repair. Women may need surgery to lift a fallen bladder or rectum into its normal position. The most common procedure for cystocele and rectocele repair involves a urologist, who also specializes in the female reproductive system, making an incision in the wall of the vagina. Through the incision, the urologist looks for a defect or hole in the tissue that normally separates the vagina from the other pelvic organs. The urologist places stitches in the tissue to close up the defect and then closes the incision in the vaginal wall with more stitches, removing any extra tissue. These stitches tighten the layers of tissue that separate the organs, creating more support for the pelvic organs. A urologist or gynecologista doctor who specializes in the female reproductive systemperforms the surgery to repair a cystocele or rectocele in a hospital. Women will receive anesthesia. Tumor and cancer surgery. Removal of tumors and cancerous tissues in the bladder or urethra may reduce urethral obstruction and urinary retention.
Source: NIDDK

Question: What are the treatments for Urinary Retention ?
Answer: Complications of urinary retention and its treatments may include - UTIs - bladder damage - kidney damage - urinary incontinence after prostate, tumor, or cancer surgery UTIs. Urine is normally sterile, and the normal flow of urine usually prevents bacteria from infecting the urinary tract. With urinary retention, the abnormal urine flow gives bacteria at the opening of the urethra a chance to infect the urinary tract. Bladder damage. If the bladder becomes stretched too far or for long periods, the muscles may be permanently damaged and lose their ability to contract. Kidney damage. In some people, urinary retention causes urine to flow backward into the kidneys. This backward flow, called reflux, may damage or scar the kidneys. Urinary incontinence after prostate, tumor, or cancer surgery. Transurethral surgery to treat benign prostatic hyperplasia may result in urinary incontinence in some men. This problem is often temporary. Most men recover their bladder control in a few weeks or months after surgery. Surgery to remove tumors or cancerous tissue in the bladder, prostate, or urethra may also result in urinary incontinence.
Source: NIDDK

Question: What to do for Urinary Retention ?
Answer: Researchers have not found that eating, diet, and nutrition play a role in causing or preventing urinary retention.
Source: NIDDK

Question: What to do for Urinary Retention ?
Answer: - Urinary retention is the inability to empty the bladder completely. - Urinary retention can be acute or chronic. - Urinary retention can result from - obstruction of the urethra - nerve problems - medications - weakened bladder muscles - The symptoms of acute urinary retention may include the following and require immediate medical attention: - inability to urinate - painful, urgent need to urinate - pain or discomfort in the lower abdomen - bloating of the lower abdomen - The symptoms of chronic urinary retention may include - urinary frequencyurination eight or more times a day - trouble beginning a urine stream - a weak or an interrupted urine stream - an urgent need to urinate with little success when trying to urinate - feeling the need to urinate after finishing urination - mild and constant discomfort in the lower abdomen and urinary tract - A health care provider diagnoses acute or chronic urinary retention with - a physical exam - postvoid residual measurement - A health care provider may use the following medical tests to help determine the cause of urinary retention: - cystoscopy - computerized tomography (CT) scans - urodynamic tests - electromyography - A health care provider treats urinary retention with - bladder drainage - urethral dilation - urethral stents - prostate medications - surgery - Complications of urinary retention and its treatments may include - urinary tract infections (UTIs) - bladder damage - kidney damage - urinary incontinence after prostate, tumor, or cancer surgery - People can prevent urinary retention before it occurs by treating some of the potential causes.
Source: NIDDK