What is acute urinary retention? – This refers to sudden painful inability to pass urine. In this situation, the bladder is full, there is the urge to pass urine but urine cannot come out despite the efforts made to do so. It is a situation that catches those affected unawares. This is an emergency that requires immediate attention by medical a practitioner.
Who is affected by acute urinary retention?
Acute urinary retention is far more common in male than female due to the difference in the structure of their urethras. It is also more common in adults than children.
What are the causes of acute urinary retention?
The following are common causes of acute urinary retention:
- Blockage to passage of urine – This may be caused by: enlarged prostate gland, bladder outlet obstruction, stone or blood clots in the urethra.
- Drugs – Some drugs can cause contraction of the smooth muscles of the urethra or the neck of the bladder, resulting in blockage to urine passage. These include: drugs used in management of allergy (antihistamines), drugs used in management of depression (antidepressants), drugs used in management of psychosis (antipsychotics), certain pain relief drugs (opiods) and blood pressure drugs.
- Impaired nerve function – This may be due to damage to the nerves that control the bladder / urethra during surgery, severe pelvic pain following pelvic surgery or sudden removal of urethral catheter following prolonged catheterization.
- Infection of the prostate – This may cause swelling of the prostate (prostatitis), leading to obstruction to urine flow.
- Urinary tract infection – This may cause to swelling in the urinary tract, leading to obstruction to urine flow.
- Sexually transmitted infection – This may cause swelling in the urinary tract, leading to obstruction to urine flow.
- Surgery – Drugs used to block pain during surgery (anaesthetic drugs) may cause sudden urinary retention after surgery.
What are the symptoms of acute urinary retention?
Someone with acute urinary retention may experience any or a combination of the following:
- Inability to pass urine at all despite the urge and efforts made to do so.
- Passing little urine despite having full bladder.
- Straining to pass urine.
- Severe lower abdominal pain.
- Restlessness.
How is acute urinary retention treated?
Due to the emergency nature of acute urinary retention, the first step in treatment is to drain the urine in the bladder. This is done by inserting urinary catheter (long narrow tube) into the bladder through the urethra. This usually provides immediate relief. After this, the cause is then sought for and treated accordingly.
How can acute urinary retention be prevented?
It is difficult to prevent acute urinary retention because of its sudden occurrence. However, the following steps may be taken to reduce the risks:
- Passing urine as soon as the urge is felt.
- Seeking medical attention as soon as any change in urine flow is noted.
- Drinking adequate water to maintain urine flow in the urinary tract. This reduces the risk of urinary tract infection.
- Avoidance of unprotected sexual intercourse with a strange partner.
- Maintenance of healthy body weight.