Urinary retention is the inability to urinate or fully empty the bladder. It can be chronic or acute, with various causes and treatments. Acute retention is a medical emergency and requires immediate catheterization. Chronic retention may be caused by prostate enlargement, urinary tract infections, or nerve damage, and requires medical attention to prevent bladder damage and infection.
Urinary retention occurs when a person cannot urinate and needs to, or can urinate only a small amount but is unable to remove urine completely from the bladder. This condition can be classified as chronic or acute, where in chronic conditions the person experiences it to a lesser or lesser degree on a fairly constant basis. It has a variety of causes and treatment depends on the cause. In a number of cases, urinary retention can be completely cured, but sometimes it can only be relieved through measures that must be taken constantly to empty the bladder.
Symptoms of urinary retention can be different depending on whether the condition is acute or chronic. Acute retention is very severe and means there is no way to urinate. A person simply cannot, no matter how hard he tries.
This form of the condition is considered extremely serious and medically urgent because continued bladder filling can lead to permanent damage. It can occur due to some damage to the bladder or the structures surrounding it, and sometimes that damage is temporary. For example, a pregnant woman who has an epidural during labor frequently experiences acute retention; to solve this problem, you may have a urinary catheter to remove urine and prevent bladder injury.
In most cases, the standard treatment for acute retention is to first use a urinary catheter to empty the bladder. Depending on the underlying causes, this may be the only treatment or additional treatments may be needed. If bladder damage or the ability to urinate is impaired for an extended period of time, regular catheterization may be necessary.
Using a catheterization for chronic urinary retention is not always necessary. In this condition, there may also be a risk of bladder damage over time, but people are able to pass some urine. Very frequently, the underlying condition of the chronic forms is the enlargement of the prostate gland; this is the most common cause and is exclusive to men. Treatment might address shrinkage of the prostate gland when this is the case.
Other causes of chronic urinary retention include urinary tract infection, weakness of the bladder and vagina or pelvic floor, problems with the urethra causing it to narrow, blockage of the urethra with bladder stones, and some medications. It’s easy to see how treatment might differ depending on the cause. A urinary tract infection may require antibiotics, bladder stones may need to be dissolved with medication or surgically removed, and some medications such as antihistamines or those used for urinary incontinence may need to be stopped.
More invasive measures may be needed if the pelvic floor weakens enough for the bladder to enter the vagina, and surgery to repair the muscles is not uncommon. Some men have a urethral stricture, which results in a much narrower path for urine to pass. The balloon catheter may be opening up this stricture, or surgical measures may be needed to create a better opening.
Sometimes the nerve damage is so significant that people require regular urinary catheterization. Training on how to properly do this under clean or sterile conditions is invaluable in preventing infection. Regular catches have a tendency to cause a much higher risk of urinary tract infection, which could lead to an acute case of urinary retention.
It should also be noted that although chronic urinary retention is less urgent than acute forms, it still requires medical treatment. The inability to sometimes go or completely empty the bladder runs the risk of a constant infection and serious damage to the bladder that could make the problem irreparable. Should this condition arise, it should be brought to the attention of a doctor immediately, so that the cause can be diagnosed and treatment can begin.
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