What are the complications of urinary retention?

From the Guidelines

Urinary retention can lead to several serious complications if left untreated, including bladder overdistension, urinary tract infections, bladder stones, kidney damage, and reduced quality of life. The most immediate complication is bladder overdistension, which can cause bladder damage and reduced contractility over time 1. Urinary tract infections are common as stagnant urine creates an ideal environment for bacterial growth. Patients may develop bladder stones from crystallization of minerals in retained urine. Kidney damage can occur due to backflow of urine (hydronephrosis), potentially leading to renal failure in severe cases. Urinary retention can also cause bladder diverticula (outpouchings in the bladder wall) and may result in overflow incontinence, where small amounts of urine leak despite the inability to empty the bladder.

Some key points to consider in the management of urinary retention include:

• The use of oral alpha blockers prior to a voiding trial to treat patients with acute urinary retention related to benign prostatic hyperplasia (BPH) 1
• The importance of informing patients who pass a successful voiding trial for acute urinary retention from BPH that they remain at increased risk for recurrent urinary retention 1
• The potential benefits and risks of different treatment options, including medications, minimally invasive procedures, and surgery 1
• The need for individualized treatment approaches, taking into account the patient's underlying condition, medical history, and personal preferences 1

In terms of specific treatment options, catheterization is often necessary to relieve immediate pressure and address the underlying cause of urinary retention. This may be followed by medications, minimally invasive procedures, or surgery to address the root cause of the condition 1. The choice of treatment will depend on the underlying cause of the urinary retention, as well as the patient's overall health and medical history.

It is also important to note that urinary retention can have a significant impact on a patient's quality of life, and that treatment should prioritize not only the relief of symptoms but also the improvement of overall well-being 1. By taking a comprehensive and individualized approach to the management of urinary retention, healthcare providers can help to minimize the risk of complications and improve patient outcomes.

From the FDA Drug Label

BPH-related urological events were defined as urological surgical intervention and acute urinary retention requiring catheterization. Acute Urinary Retention Requiring Catheterization 6.6 2.8 The risk of developing acute urinary retention was reduced by 67% in patients treated with finasteride tablets compared to patients treated with placebo (0.8% for finasteride tablets and 2.4% for placebo).

The complications of urinary retention include the need for catheterization and increased risk of urological surgical intervention. Additionally, acute urinary retention can lead to BPH-related urological events. According to the study, treatment with finasteride tablets can reduce the risk of developing acute urinary retention by 67% compared to placebo 2, 2, 2.

• Key complications:
  • Need for catheterization
  • Urological surgical intervention
  • BPH-related urological events
• Risk reduction with finasteride tablets: 67% reduction in risk of acute urinary retention compared to placebo.

From the Research

Complications of Urinary Retention

• Urinary retention can lead to various complications, including bladder damage, kidney damage, and urinary tract infections 3
• The condition can also cause discomfort, pain, and embarrassment, affecting a person's quality of life
• In severe cases, urinary retention can lead to long-term damage to the bladder and kidneys, resulting in chronic health problems

Causes of Urinary Retention

• Benign prostatic hyperplasia (BPH) is a common cause of urinary retention, accounting for 53% of cases 3
• Other causes include infectious, inflammatory, iatrogenic, and neurologic factors
• Medications, such as certain antidepressants and antihistamines, can also contribute to urinary retention

Treatment and Management

• Initial management of urinary retention involves assessment of urethral patency and prompt bladder decompression by catheterization 3
• Alpha-blockers, such as tamsulosin, can be effective in treating urinary retention caused by BPH 4, 5, 6
• The addition of tadalafil to tamsulosin may not provide significant benefits in improving urinary retention 7

Potential Consequences of Untreated Urinary Retention

• Untreated urinary retention can lead to long-term damage to the bladder and kidneys
• It can also increase the risk of urinary tract infections and other complications
• Prompt medical attention is essential to prevent these potential consequences and to manage the condition effectively 3