Does It Cause Urinary Retention?
The question "Does it cause urinary voiding" is unclear, but if asking whether something causes urinary retention (inability to empty the bladder), the answer depends entirely on what "it" refers to—certain medications, medical conditions, and procedures can indeed cause urinary retention.
Medications That Cause Urinary Retention
- Anticholinergic medications (antipsychotics, antidepressants, antimuscarinics for overactive bladder) directly impair detrusor contractility and are well-established causes of urinary retention 1
- Antimuscarinic medications for overactive bladder carry specific warnings about urinary retention risk, ranging from 2.6-54% in some studies 1
- Quetiapine poses substantially elevated risk in elderly patients, particularly when combined with other anticholinergic medications or in patients with benign prostatic hyperplasia 1
- Sympathomimetic agents like lisdexamfetamine stimulate alpha-adrenergic receptors in the bladder neck and urethra, increasing urinary retention risk 2
- OnabotulinumtoxinA (Botox) for neurogenic bladder carries a 20.49% risk of urinary retention 2
Medical Conditions That Cause Urinary Retention
- Benign prostatic hyperplasia (BPH) is the overwhelming cause of obstructive voiding in men 3
- Neurological conditions including spinal cord injuries affecting sacral nerves S2-S4, multiple sclerosis, Parkinson's disease, and stroke (affecting 25-50% of stroke survivors) can cause urinary retention 2
- Urethral strictures and bladder outlet obstruction from anatomic causes lead to retention 4
- Constipation can cause urinary retention, particularly in elderly patients 4
Clinical Recognition of Urinary Retention
- Voiding symptoms include slow stream, splitting/spraying, intermittency, hesitancy, straining, and terminal dribble—all suggesting lower urinary tract obstruction 5
- Post-void residual (PVR) assessment should be performed in patients with emptying symptoms, history of retention, enlarged prostate, neurologic disorders, prior surgery, or long-standing diabetes 6
- In mice models, urinary retention presents as inability to urinate during handling, difficult manual bladder expression, caudal abdominal bulge, and enlarged bladder on palpation 6
Key Risk Factors
- Male gender and advanced age are crucial risk factors for urinary retention 2
- Pre-existing lower urinary tract symptoms increase risk 2
- Postmenopausal women with urinary incontinence, cystocele, or high post-void residuals face increased risk 6
Important Caveats
- Antimuscarinic medications should be used with extreme caution in patients with impaired gastric emptying or history of urinary retention 2
- Combining quetiapine with other anticholinergic medications substantially increases urinary retention risk and should be avoided 1
- Elderly patients require special consideration due to age-related bladder dysfunction, particularly when using medications with anticholinergic properties 1
- Post-micturition dribble can indicate either incomplete emptying (voiding symptom) or incontinence (storage symptom) depending on context, requiring detailed evaluation with uroflowmetry and post-void residual measurement 5