From the Guidelines
Holding urine in for extended periods can indeed lead to urinary retention, as it can weaken the bladder muscles and reduce their ability to empty the bladder completely. This is a concern because urinary retention can lead to increased morbidity, mortality, and decreased quality of life due to potential complications such as urinary tract infections, bladder damage, and kidney damage 1.
When considering the management of urinary retention, it's essential to look at the most recent and highest quality studies. According to a 2021 guideline on the management of lower urinary tract symptoms attributed to benign prostatic hyperplasia, physicians should prescribe an oral alpha blocker prior to a voiding trial to treat patients with acute urinary retention (AUR) related to BPH 1. This guideline also suggests that patients newly treated for AUR with alpha blockers should complete at least three days of medical therapy prior to attempting a trial without a catheter (TWOC) 1.
Some key points to consider when addressing urinary retention include:
- The importance of not ignoring the body's signals to urinate, as this can disrupt the natural communication system between the bladder and brain
- The need for regular bathroom breaks, especially for individuals with existing urinary problems or neurological conditions
- The potential benefits of alpha blocker therapy in treating AUR, as demonstrated by studies showing improved TWOC success rates with alfuzosin or tamsulosin compared to placebo 1
- The importance of monitoring for recurrent urinary retention, as patients who pass a successful TWOC for AUR from BPH remain at increased risk 1
Overall, it's crucial to prioritize the prevention and management of urinary retention to minimize its impact on morbidity, mortality, and quality of life. By taking a proactive approach to addressing urinary retention, individuals can reduce their risk of complications and improve their overall health outcomes.
From the Research
Causes of Urinary Retention
- Urinary retention can be caused by various factors, including obstructive, infectious, inflammatory, pharmacologic, neurologic, or other causes 2, 3
- The most common cause of urinary retention is benign prostatic hyperplasia, especially in men 2, 3
- Other common causes include prostatitis, cystitis, urethritis, and vulvovaginitis, as well as receiving medications in the anticholinergic and alpha-adrenergic agonist classes 2
Relationship Between Holding Urine and Urinary Retention
- There is no direct evidence to suggest that holding urine in can result in urinary retention 2, 3, 4, 5, 6
- However, urinary retention can be caused by various factors, and holding urine in for an extended period may exacerbate underlying conditions that contribute to urinary retention
Management of Urinary Retention
- Initial management of urinary retention involves assessment of urethral patency with prompt and complete bladder decompression by catheterization 2, 3
- Alpha blockers may be used to improve urinary symptoms and increase the success rates of trial without catheter 4, 5
- Suprapubic catheterization may be superior to urethral catheterization for short-term management, and silver alloy-impregnated urethral catheters may reduce urinary tract infection 2