What is the relationship between Celebrex (Celecoxib) and urinary retention?

From the Guidelines

Celebrex (celecoxib) is not directly associated with urinary retention as a common side effect, but certain medications that can cause urinary retention, such as antiarrhythmic drugs, particularly class IA, can have anticholinergic effects, including urinary retention, as noted in a 2022 review by the European Society of Cardiology working group on cardiovascular pharmacotherapy 1. When considering the relationship between Celebrex and urinary retention, it's essential to examine the potential indirect effects of Celebrex on urinary function. As a COX-2 inhibitor, a type of nonsteroidal anti-inflammatory drug (NSAID), Celebrex primarily affects pain and inflammation. However, NSAIDs can indirectly influence urinary function through their effects on prostaglandin production, which plays a role in maintaining bladder contractility and urine flow. Some key points to consider:

• Urinary retention risk may be higher in older adults, males with enlarged prostates, or those with pre-existing bladder issues.
• If you're in these risk groups, your doctor might recommend monitoring for urinary symptoms. To minimize the risk of urinary problems while taking Celebrex:

1. Stay well-hydrated
2. Urinate regularly, don't hold it for long periods
3. Report any changes in urinary habits to your doctor promptly It's crucial to note that the benefits of Celebrex in managing pain and inflammation often outweigh this uncommon risk for most patients. However, if urinary retention occurs, your doctor may consider alternative pain management strategies or prescribe medications to improve bladder function, as seen with other medications that have anticholinergic effects, such as class IA antiarrhythmic drugs 1.

From the Research

Relationship between Celebrex (Celecoxib) and Urinary Retention

• There is no direct evidence in the provided studies that links Celebrex (Celecoxib) to urinary retention.
• However, according to the study 2, NSAIDs (Non-Steroidal Anti-Inflammatory Drugs), which include Celecoxib, have been associated with urinary retention.
• The study 2 also mentions that elderly patients are at higher risk for developing drug-induced urinary retention due to existing co-morbidities and the use of other concomitant medication.
• The study 3 mentions that analgesics, which is a broader category of drugs that includes NSAIDs, can cause urinary retention due to failure of bladder contraction.
• The study 4 provides a comprehensive overview of urinary retention, including its causes, diagnosis, and management, but does not specifically mention Celecoxib or NSAIDs as a cause of urinary retention.

Mechanism of Urinary Retention

• The study 2 explains that urinary retention can be caused by drugs that interact with the micturition pathway, including those with anticholinergic activity, opioids, and alpha-adrenoceptor agonists.
• The study 3 mentions that anticholinergics, anaesthetics, and analgesics can cause urinary retention due to failure of bladder contraction.
• The study 5 mentions that urinary retention can be caused by medications, including antichitergics and antidepressants, and that the treatment requires urgent placement of a urinary catheter into the bladder.

Management and Prevention of Urinary Retention

• The study 2 suggests that drug-induced urinary retention is generally treated by urinary catheterization, especially if acute, in combination with discontinuation or a reduction in dose of the causal drug.
• The study 4 recommends that initial management of urinary retention includes bladder catheterization with prompt and complete decompression, and that definitive management will depend on the etiology of the condition.