Can urinary retention be causing my current symptoms?

Urinary Retention as a Potential Cause of Current Symptoms

Yes, urinary retention could be causing your current symptoms, especially if you're experiencing discomfort in the lower abdomen, difficulty urinating, or a sensation of incomplete bladder emptying. 1

Signs and Symptoms of Urinary Retention

Urinary retention presents with several characteristic symptoms:

• Inability to voluntarily void or difficulty initiating urination 2
• Lower abdominal discomfort or pain 3
• Sensation of incomplete bladder emptying 2
• Frequent small-volume voids (overflow incontinence) 3
• In severe cases, a palpable or distended bladder 1

Causes of Urinary Retention

Urinary retention can be acute or chronic and has multiple potential causes:

• Obstructive causes:

  • Benign prostatic hyperplasia (accounts for 53% of cases) 2
  • Urethral stricture or obstruction 3
  • Pelvic organ prolapse in women 4

• Medication-induced causes:

  • Anticholinergic medications (including oxybutynin) 5
  • Alpha-adrenergic agonists 6
  • Opioids and anesthetics 6
  • Benzodiazepines 6

• Neurological causes:

  • Neurogenic bladder from stroke, multiple sclerosis, or spinal cord injury 1
  • Diabetic neuropathy 3

• Inflammatory causes:

  • Prostatitis, cystitis, urethritis 4

Evaluation for Urinary Retention

If you suspect urinary retention:

• Measure post-void residual (PVR) urine volume - a PVR >100-200 mL warrants caution 1
• A PVR >300 mL on two separate occasions persisting for at least six months defines chronic urinary retention 2
• Assess for bladder distension through physical examination 1
• Consider urodynamic studies if symptoms persist despite initial management 1

Management of Urinary Retention

Immediate management includes:

• Bladder decompression through catheterization (urethral or suprapubic) 1, 4
• For medication-induced retention, discontinuation or dose reduction of the causative agent 6
• For men with BPH-related retention, starting alpha-blockers at the time of catheter insertion improves chances of returning to normal voiding 4

Complications of Untreated Urinary Retention

If left untreated, urinary retention can lead to:

• Urinary tract infections 1
• Bladder damage from overdistension 3
• Renal impairment 3
• Electrolyte disturbances including hyponatremia 7

Special Considerations

• Elderly patients are at higher risk for developing drug-induced urinary retention due to comorbidities and polypharmacy 6
• Patients with neurogenic bladder may require long-term management with clean intermittent self-catheterization 1
• Suprapubic catheterization may be superior to urethral catheterization for short-term management 4

If you're experiencing symptoms suggestive of urinary retention, prompt medical evaluation is essential to prevent complications and determine the underlying cause.