Urinary retention is a condition that occurs when someone is not able to empty their bladder completely. Instead of all the urine being passed out through the urethra, some remains in the bladder.
Urinary retention can be a short-term or long-term problem and can occur suddenly (acute) or get worse over a period of time (chronic).
Retaining urine in the bladder can further lead to urinary incontinence and urinary tract infections. In major cases, urine can start to ‘back up’ the ureters to the kidneys, causing long-term damage.
What causes urinary retention?
There are many potential causes of urinary retention that includes:
- Structural problems with the urethra, like narrowing (stricture) or blockage
- Weak bladder and pelvic floor muscles
- Problems with nerve messages travelling between the bladder and brain
- By side effect of some medications, including anesthesia
- Following surgery to the urinary system
How is urinary retention diagnosed?
The initial stage in diagnosis is where the doctor records a clinic history of when the problem started and how often it happens. They will generally perform a physical test to see if the bladder feels hard as it is full of urine or if there are any signs of constipation. They can also perform an ultrasound scan of the bladder and kidneys.
Some of the children can benefit from having a micturating cystourethrogram (MCUG), which is a scan that shows how well the child’s bladder is working. This is used to diagnose why the child is having urinary tract infections. It is also used to show up any abnormalities with the child’s urinary system.
Another test that the doctor might advise is a cystoscopy. It is a test which helps the doctor to look within and around the child’s bladder using a cystoscope (a tube containing a small camera and a light).
What are the symptoms of urinary retention?
Acute urinary retention is extremely painful condition and causes abdominal bloating. There may not be any noticeable symptoms present with chronic urinary retention. If present, symptoms can include urinary incontinence and urinary tract infections.
How is urinary retention treated?
Acute urinary retention needs emergency treatment to lower down the pressure on bladder and abdomen.
Generally treatment involves placing a catheter into the urethra and passing it through the sphincter into the bladder so that urine can be drained into a collection bag.
If the urethra is obstructed so the catheter is unable pass through it, the catheter may be inserted through the skin into the bladder and drained that way.
Once the bladder has been drained, doctors will carry out various tests to find out why the urinary retention happened. Generally chronic urinary retention does not need any sort of emergency treatment but it should be fully checked to lower down the risk of infection and damage to the kidneys.
If there is a structural problem that is causing urinary retention, surgery may be needed to correct it.
For example, if there is a urethral stricture then the urethra can be stretched or dilated, and may need a stent (plastic tube) inserted to keep the urethra open. If the urethra is blocked, extraction of the blockage during an operation will be needed.