From the Guidelines
The medical term for difficulty urinating is actually urinary retention or obstructive uropathy, but more specifically, the term that refers to the symptoms of difficulty urinating is Lower Urinary Tract Symptoms (LUTS), which includes voiding symptoms such as weak stream, straining, and difficulty initiating urination. This condition refers to a range of symptoms that can cause discomfort, pain, or difficulty while urinating, and is often accompanied by a weak stream, straining, or difficulty initiating urination. LUTS can be caused by various conditions including benign prostatic hyperplasia (BPH), prostatitis in men, urethral stricture, or side effects from certain medications. If experiencing LUTS, it's essential to seek medical attention as treatment depends on the underlying cause. Some key points to consider when evaluating LUTS include:
- The standard patient is a man older than 50 years consulting a qualified health care provider for LUTS, which may or may not be associated with an enlarged prostate gland, bladder outlet obstruction (BOO), or histological BPH 1.
- LUTS is divided into storage symptoms, which are experienced during the storage phase of the bladder, and voiding symptoms, which are experienced during the voiding phase 1.
- The most prevalent and generally first-line approach is behavioral and lifestyle modifications followed by medical therapy, including alpha-adrenergic antagonists (alpha blockers), 5-alpha reductase inhibitors (5ARIs), phosphodiesterase 5 selective inhibitors (PDE5s), anticholinergics, and beta-3 agonists - which may be utilized alone, or in combination to take advantage of their different mechanisms of action 1.
- While LUTS/BPH is rarely life-threatening, the impact on quality of life (QoL) is significant and should not be underestimated 1.
From the Research
Definition and Causes
- The medical term for difficulty urinating is urinary retention, which is the acute or chronic inability to voluntarily pass an adequate amount of urine 2.
- The condition predominantly affects men, with benign prostatic hyperplasia accounting for 53% of cases 2.
- Other causes of urinary retention include infectious, inflammatory, iatrogenic, and neurologic factors 2.
Symptoms and Diagnosis
- Urinary retention can be acute or chronic, with chronic urinary retention defined as a postvoid residual (PVR) volume greater than 300 mL measured on two separate occasions and persisting for at least six months 2.
- Initial evaluation should involve a detailed history and physical examination, including neurologic evaluation, and diagnostic testing such as measurement of PVR volume 2.
Management and Treatment
- Initial management of urinary retention involves assessment of urethral patency and prompt and complete bladder decompression by catheterization 2.
- Alpha-blockers can be used to facilitate catheter removal and prevent further episodes of urinary retention 3, 4.
- Surgical treatment, such as transurethral resection of the prostate (TURP), may be necessary in some cases, but is associated with relatively more complications than other available surgical and minimally invasive procedures 5, 6.