From the Research
Yes, advanced prostate cancer can cause urinary retention, as evidenced by a recent case report in 2020 1 where a metastatic bladder tumor from prostate cancer caused a ball valve-like obstruction in urination. As prostate cancer progresses, the tumor can grow large enough to compress or block the urethra, preventing normal urine flow and leading to partial or complete urinary retention. This obstruction typically develops gradually, with symptoms including weak urine stream, difficulty starting urination, frequent urination (especially at night), and the sensation of incomplete bladder emptying. In advanced cases, patients may experience complete inability to urinate, bladder distension, and overflow incontinence. Treatment depends on the severity and may include catheterization (either intermittent or indwelling), medications like alpha-blockers (tamsulosin, alfuzosin), or procedures to relieve the obstruction, such as transurethral resection of the prostate (TURP) as shown in studies from 1994 2, 2004 3, and 2006 4. The underlying prostate cancer treatment is also essential, which may involve hormone therapy, chemotherapy, radiation, or other approaches depending on the cancer stage, and can impact the management of urinary retention, as seen in a study from 1994 5 where orchiectomy followed by removal of the indwelling catheter was effective in some patients. Urinary retention in advanced prostate cancer occurs because the anatomical location of the prostate surrounds the urethra, making it particularly susceptible to causing obstruction as the tumor enlarges and invades surrounding tissues. Key considerations in managing urinary retention in advanced prostate cancer include:
- The need for prompt relief of obstruction to prevent complications such as bladder distension and overflow incontinence
- The importance of addressing the underlying prostate cancer with appropriate treatment
- The role of procedures like TURP in relieving obstruction and improving urinary symptoms
- The potential for metastatic disease to cause urinary obstruction, as highlighted in the 2020 case report 1.