Urinary retention is a condition where the bladder does not empty completely. There are, of course, varying degrees of urinary retention. Some individuals cannot empty their bladder at all, while others retain only a small amount of urine after urination. The type of treatment required depends on the cause and degree of urinary retention. If urinary retention is your main problem we will review your history, do a urologic exam, and likely evaluate your bladder function with urodynamic testing. We are first looking for correctable causes, if any, for urinary retention. If no correctable cause is identified, we will then discuss long term management options.
The causes of urinary retention can be grouped into two broad categories. First, urinary retention can be due to failure of the urinary bladder to contract or squeeze sufficiently to empty completely. Second, urinary retention may be due to obstruction of the bladder outlet. High grade obstruction can cause even a normally contractile bladder to empty incompletely or not at all.
Failure of the bladder to contract sufficiently may be due to problems with the nerves leading to the bladder as in spine or back disease, or any other neurologic condition that affects the nerves going to the bladder. We frequently see retention in individuals with lumbar disc disease, spinal cord injury, multiple sclerosis, etc. Retention may also be due to failure of the bladder muscle to contract. This problem may due to chronic bladder distention or sensory injury to the bladder as seen in diabetes.
Bladder outlet obstruction is a common cause of urinary retention in men. Obstruction can be caused by growth of the prostate (BPH) obstructing the urethra (urine tube), primary bladder neck obstruction, or urethral strictures.
Work-up with urodynamic testing and cystoscopy evaluates the bladder, bladder outlet, prostate, and urethra. In the majority of cases we can determine the specific area causing urinary retention and offer possible treatment options.
