Medical Terminology for Incomplete Bladder Emptying in Males
The medical term for the inability to fully empty the bladder is "urinary retention," which can be classified as either acute or chronic depending on presentation and duration. 1
Primary Terminology
Urinary retention is formally defined as the acute or chronic inability to voluntarily pass an adequate amount of urine, despite having adequate volume in the bladder. 1 This condition predominantly affects males and represents a spectrum from minor symptoms to complete inability to void. 2
Classification Systems
Acute vs. Chronic Retention
Acute urinary retention presents as a sudden, painful inability to void with a palpably distended bladder requiring immediate catheterization. 1
Chronic urinary retention (CUR) is defined by the International Continence Society as "a non-painful bladder which remains palpable or percussable after the patient has passed urine." 3
Defining Chronic Retention by Residual Volume
The definition of chronic retention varies significantly across guidelines based on post-void residual (PVR) volume:
The American Urological Association recommends defining chronic urinary retention as PVR volume greater than 300 mL measured on two separate occasions and persisting for at least six months. 1
UK NICE guidelines define CUR as a PVR of >1000 mL. 3
Historical definitions used >300 mL as the threshold, based on the assumption this represents the minimum volume at which the bladder becomes palpable suprapubically. 3
Important caveat: There is no worldwide consensus on the PVR threshold that defines significant retention, and the ability to palpate a bladder depends on multiple variables including clinician skill and patient body habitus. 3 PVR measurements should be repeated to improve precision due to marked variability. 3
Related Terminology in Males
Obstructive Voiding Dysfunction
Obstructive voiding dysfunction describes difficulty in volitional bladder emptying ranging from minor irritative symptoms to complete retention. 2
In males, benign prostatic hyperplasia accounts for 53% of urinary retention cases and is the overwhelming cause of obstructive voiding. 1, 2
Bladder outlet obstruction (BOO) is the generic term for all forms of obstruction to the bladder outlet, including benign prostatic obstruction and urethral stricture. 4
Voiding Symptoms
The International Continence Society categorizes voiding symptoms (also called obstructive symptoms) as those experienced during the voiding phase, including: 5
- Slow stream
- Splitting or spraying
- Intermittency
- Hesitancy
- Straining
- Terminal dribble
Post-Micturition Symptoms
Post-micturition symptoms experienced immediately after voiding include: 5
- Feeling of incomplete emptying
- Post-micturition dribble (involuntary urine loss after finishing urination)
Neurogenic Causes
Detrusor underactivity with dysfunctional voiding can result in episodes of hesitancy, urge incontinence, or overflow incontinence. 6
Detrusor decompensation represents the clinical endpoint of chronic high-pressure bladder conditions. 6
Acontractile detrusor describes a bladder that cannot generate adequate contractile force for complete emptying. 6
Clinical Pitfalls
Avoid imprecise terminology: Terms like "BPH patient," "symptomatic BPH," or "clinical BPH" are imprecise and cause confusion—they should not be used interchangeably with urinary retention or lower urinary tract symptoms. 4 The presence of prostatic enlargement does not automatically mean obstruction or retention exists.
Palpable bladder is unreliable: The traditional definition of chronic retention requiring a "palpable or percussable bladder" is problematic because no studies have objectively assessed at what urine volume a bladder becomes palpable, and this varies with individual factors. 3