What is urinary retention?
urinary retentiveness is the soundbox ’ s inability to completely empty the bladder — it can be classed as either acute accent or chronic .
Acute urinary retention — comes on quite suddenly and can cause big discomfort or pain. With acute urinary memory, a person can not urinate at all ( even if they have a full bladder ) and is a potentially dangerous checkup condition requiring contiguous hand brake treatment .
Chronic urinary retention — can be a durable medical condition. People with chronic urinary retentiveness can urinate, but they can not completely empty all of the urine from their bladders. sometimes, a person is not aware they have this condition until early problems present like Urinary Incontinence, or a urinary Tract Infection.
urinary retentiveness can affect anyone. however, men in their fifties and sixties are more susceptible, primarily because of an enlarge prostate gland .
A charwoman can besides be affected by urinary retentiveness if she suffered from a condition called Cystocele, where the bladder starts to sag or moves out of its normal situation. It can besides be pulled out of situation when the lower character of the colon starts to sag — a condition called Rectocele .
What causes urinary retention?
urinary memory can be attributed to two causes — either obstruction or non-obstruction .
If there is an obstruction ( for case, bladder or kidney stones ), a obstruction happen and urine can not flow unimpeded through your urinary track. This is the footing for acute urinary retention and is potentially liveliness threatening. You must seek contiguous emergency treatment .
Non-obstructive causes include a de-escalate bladder muscle and steel problems that interfere with signals between your mind and the bladder. If the nerves aren ’ metric ton working properly, your genius may not get the message that the bladder is full .
clogging urinary retention causes include :
- Enlarged prostate (BPH) in men
- Certain tumours and cancers
- Urethral stricture
- Cystocele or rectocele,
- Kidney or bladder stones
common causes of non-obstructive urinary retention are :
- Vaginal childbirth
- Pelvic injury or trauma
- Nerve disease in both men and women
- Impaired muscle or nerve function due to medication or anaesthesia
- Accidents that injure the brain or spinal cord
What are the symptoms of urinary retention?
Symptoms of urinary memory differ according to whether you ’ ra suffer from Acute or Chronic urinary retention :
Acute urinary memory symptoms require immediate aesculapian attention :
- Inability to urinate
- Painful, urgent need to urinate
- Severe pain or discomfort in the lower abdomen
- Bloating of the lower abdomen
Chronic urinary retention symptoms may include
- Urinary frequency — urination eight or more times a day
- Trouble beginning a urine stream
- Weak or an interrupted urine stream
- Urgent need to urinate with little success when trying to urinate
- Feeling the need to urinate after finishing urination
- Mild and constant discomfort in the lower abdomen and urinary tract
- Difficulty fully emptying the bladder
- Urge incontinence
- Inability to feel when bladder is full
- Increased abdominal pressure
- Strained efforts to push urine out of the bladder
- Nocturia (waking up more than two times at night to urinate)
How is urinary retention diagnosed?
For acute urinary retentiveness, the signs are much obvious. For exercise, you will be extremely uncomfortable, unable to pass urine and have a distended bladder. For chronic urinary retentions the diagnosis may merely come after your doctor performs a series of tests. This is because some of the symptoms are shared with early conditions related to the bladder and urinary tract .
identical often, and specially in men, an enlarge prostate gland can be the perpetrator and treatment can begin consequently. In these instances, doctors will rely on aesculapian history and a physical examen to determine if urinary retention is a concern. They will besides look out for more dangerous urinary retention causes, such as cauda equina or spinal anesthesia cord compression .
broadly though, your doctor of the church will diagnose acute or chronic urinary retention with a :
- Physical examination — A physical exam of the lower abdomen will determine if you have a distended bladder by lightly tapping on the lower belly.
- Post void residual measurement — Using an ultrasound, this test measures the amount of urine left in the bladder after urination. Your doctor may also use a catheter to measure post void residual (usually under local anaesthetic).
additionally, they may use these tests to help determine the cause of urinary retentiveness :
- Cystoscopy — Using an instrument called a cystoscope, your doctor will look inside the urethra and bladder for any abnormalities.
- Computerised tomography (CT) scans — A combination of x rays and computer technology creates images that can show things like: urinary tract stones, urinary tract infections
, tumours, traumatic injuries and scarring and cysts.
- Urodynamic tests including:
- Uroflowmetry — To measure urine speed and volume
- Pressure flow study — To measure the bladder pressure required to urinate and the flow rate a given pressure generates
- Video urodynamics — To create real-time images (using x-ray or ultrasound) of the bladder and urethra during the filling or emptying of the bladder.
- Electromyography — Using special sensors to measure the electrical activity of the muscles and nerves in and around the bladder and sphincters.
How is urinary retention treated?
Your doctor/specialist may treat your urinary retentiveness with
- bladder drainage
- urethral dilation
- urethral stents
- prostate medications
The type and duration of treatment will depend on the type and lawsuit of urinary retentiveness .
Bladder drain is the function of a catheter to drain urine. Acute urinary retentiveness treatment normally starts with catheterization to relieve the distress of a full bladder and to prevent further bladder damage. Under local anaesthetic, a sophisticate passes a catheter through the urethra into the bladder where drain of urine can then begin. Sometimes a urethra can become obstruct. If this happens, your doctor of the church will administer anesthesia, then insert a catheter through the lower abdomen, precisely above the pubic bone, immediately into the bladder .
If other treatments for chronic urinary retention don ’ metric ton work, you may require episodic or long-run catheterization and will receive direction from your sophisticate on how to self catheterize to drain urine when necessary .
urethral dilation is used to treat urethral stenosis. This is done by inserting increasingly wider tubes into the urethra, or inflating a minor balloon at the end of a catheter inside the urethra. Both methods widen the stricture to allow an easier hang of urine. The procedure is normally performed under local anesthesia, but in some cases you might receive sedation and regional anesthesia .
Another treatment for urethral stenosis involves inserting an artificial tube, called a stent, into the urethra to the area of the stenosis. Stents may be impermanent or permanent and once in place, expands like a bounce and pushes back the smother tissue, widening the urethra .
Your doctor may prescribe one or a combination of medications to stop the emergence of or shrink the prostate or relieve urinary retentiveness symptoms associated with Benign Prostatic Hyperplasia ( enlarge prostate ) .
What are the complications of urinary retention and its treatments?
Some complications of urinary retentiveness and its treatments may include :
- Urinary Tract Infections — Because urine is normally sterile and the normal flow of urine usually prevents bacteria from infecting the urinary tract, developing urinary retention means an abnormal urine flow gives bacteria at the opening of the urethra a chance to infect the urinary tract.
- Bladder damage — If your bladder is stretched too far or for extended periods, the muscles may become permanently damaged and lose their ability to properly contract.
- Kidney damage — Sometime urinary retention can cause urine to flow back into the kidneys. This is called reflux and can damage or scar the kidneys.
- Urinary incontinence (after prostate, tumour, or cancer surgery) — Transurethral surgery to treat an enlarged prostate can result in urinary incontinence in some men. It’s often temporary with most men gaining bladder control in a few weeks or months after surgery. The removal of tumours or cancerous tissue in the bladder, prostate, or urethra may also result in urinary dissoluteness.
How can urinary retention be prevented
If you have an enlarged prostate, be certain to take prostate gland medications as prescribed by your sophisticate and invalidate medications associated with urinary memory, such as nonprescription cold and allergy medications that contain decongestants .
If you have mild cystocele or rectocele, you may be able to prevent urinary retentiveness by doing exercises to strengthen the pelvic muscles .
Kimberly-Clark Australia makes no warranties or representations regarding the completeness or accuracy of the information. This information should be used only as a steer and should not be relied upon as a substitute for professional aesculapian or early health professional advice.
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