15427 Urinary Retention

Overview

Urinary retention is the medical term for not being able to empty your bladder fully when you pass urine. It can happen suddenly or build up over time.

Yes, it is fairly common, particularly in older men. Many cases are treatable.

It can affect anyone, but it occurs most often in older men with prostate problems. It can also affect women, especially after childbirth, and people with nerve conditions such as diabetes or spinal injury.

Symptoms

Common symptoms

• Difficulty starting to urinate
• Weak or trickling urine stream
• Feeling that your bladder is not completely empty after urinating
• Needing to urinate often, especially at night
• Sudden strong urge to urinate that is hard to control
• Straining or pushing to pass urine

Symptoms in children

• Your child may complain of pain or a burning feeling when passing urine
• Frequent accidents or wetting themselves despite wanting to go
• Dribbling urine throughout the day
• Visible swelling in the tummy area

Symptoms in older adults

• Confusion or change in behaviour (sometimes mistaken for dementia)
• Weak stream or difficulty starting
• Unexpected urine leakage (overflow incontinence)
• Abdominal discomfort or a firm lump in the lower tummy

Causes

Main causes

• Blockage in the urinary tract – for example, an enlarged prostate in men, constipation, or a narrowing (stricture) of the urethra
• Nerve problems that weaken bladder muscles – such as diabetes, stroke, spinal injury, or pelvic surgery
• Certain medications – including some cold remedies, muscle relaxants, and medicine for an overactive bladder (ask your doctor or pharmacist if you are concerned)
• Pelvic organ prolapse in women (when a pelvic organ pushes against the bladder)
• Childbirth or pelvic floor damage
• Recent surgery, especially in the pelvis or hip

Risk factors

• Being male and over age 50
• Having an enlarged prostate
• Diabetes (especially with poor blood sugar control)
• Constipation
• Taking medication that affects bladder muscle contraction
• Recent surgery with a urinary catheter (a tube to drain urine)

When to see a doctor

See a doctor urgently if:

• If you cannot pass urine at all, seek emergency medical care immediately
• If you have severe lower tummy pain or swelling along with the inability to urinate
• If you have high fever, chills and vomiting with urinary symptoms

Book a routine appointment if:

• If you notice a weak stream, dribbling, or a feeling of incomplete emptying that is not getting worse quickly
• If you are waking up to urinate more than twice a night
• If you have pelvic pain or discomfort
• If you have a history of urinary retention and changes in your usual symptoms

Diagnosis

A doctor will ask about your symptoms, examine you, and may check how much urine remains in your bladder after you urinate using a painless ultrasound scan. They may also take a urine sample to look for infection.

Tests that may be done

• Urine test (to check for infection or blood)
• Bladder scan (a small ultrasound to see how much urine is left after you pee)
• Blood tests (to check how well your kidneys are working and look for signs of prostate problems in men)
• Uroflowmetry (a test that measures your urine flow speed)
• Cystoscopy (a thin tube with a camera to look inside your bladder) – usually arranged by a specialist if needed

What to expect at your appointment

Most tests are quick and painless. You may be asked to catch a urine sample and occasionally to have a full bladder for an ultrasound. A specialist may refer you for further tests if the cause is not clear.

Treatment

Treatment depends on the cause and whether the retention is sudden (acute) or long-term (chronic). A sudden blockage is usually treated with a catheter (a thin tube) to drain the bladder urgently. For long-term retention, the aim is to treat the underlying cause, such as prostate enlargement, constipation, or nerve-related issues, and to help you empty your bladder regularly and comfortably.

Self-care at home

• Go to the toilet when you feel the urge – don't hold on for long
• Sit down and relax on the toilet; take your time
• Try a technique called 'double voiding' – after you finish, wait 30 seconds and try again
• Avoid caffeine, alcohol and fizzy drinks, especially later in the evening
• Ask your pharmacist about gentle laxative use if constipation is a problem (always read the label and consult your pharmacist if unsure)

Medical treatments

Healthcare professionals might recommend treatments such as medicines to relax the prostate (for an enlarged prostate) or to reduce the pressure in the bladder. For some people, a small catheter may be provided to use at set times each day to empty the bladder. In other cases, nerve stimulation or pelvic floor therapy can help. Always follow your doctor's advice and ask about the benefits, risks, and alternatives. No medication is mentioned here by brand name – your doctor will explain specific options.

When is surgery considered?

If medication and self-care do not work, surgery may help. For men with an enlarged prostate, a procedure to reduce the size of the prostate (such as a TURP – transurethral resection of the prostate) might be recommended. Other surgical options, such as implanting a small device near the bladder to help it drain, are also available in some centres for specific problems.

Living with this condition

If you have urinary retention, you can still enjoy a full life. Learn the best way to empty your bladder, keep to a regular toileting schedule, and carry a small supply of continence pads if you notice dribbling. Plan trips so you know where toilets are, and talk to your doctor about any changes in symptoms.

Lifestyle tips

• Keep active – avoid long periods of sitting still
• Maintain a healthy weight (excess weight can press on the bladder)
• Do not drink too much fluid late in the evening – aim for around 1.5–2 litres across the day unless your doctor says otherwise
• If you smoke, ask about support to stop – cough from smoking can weaken the pelvic floor
• Wear loose, comfortable clothing that is easy to remove

Diet and exercise

Eat plenty of fibre (fruit, vegetables, whole grains) and drink enough water to avoid constipation, since a packed rectum can press on the bladder and make retention worse. Pelvic floor exercises, which involve squeezing and relaxing the muscles you use to stop the flow of urine, can also strengthen the area. Your doctor or physiotherapist can teach you how to do them correctly.

Mental health and emotional wellbeing

Living with urinary retention can be frustrating, embarrassing, or worrying. It is normal to feel this way. Remember that it is a medical condition, not a personal failure. Talk to someone you trust, and consider telling a family member or close friend so they can support you. Your doctor can also refer you to a continence specialist or counselling if you find it hard to cope.

Prevention

You cannot always prevent urinary retention, but a healthy lifestyle and good toileting habits can reduce your risk. Keep your bowel regular, avoid holding urine for a long time, and review your medications with your doctor or pharmacist if your urinary symptoms develop after starting a new drug.

Vaccines

There is no vaccine for urinary retention. It is still a good idea to keep up with your routine immunisations to protect your overall health.

Screening programmes

Routine screening for urinary retention is not usually done. However, if you are a man over 50, it is a good idea to have a regular discussion with your GP about any urinary symptoms. Women who have had pelvic surgery or childbirth may benefit from regular pelvic floor checks with their healthcare provider.

Complications

If left untreated

• Urinary tract infections (UTIs) that can spread to the kidneys
• Damage to the bladder muscle, leading to permanent loss of bladder function
• Kidney damage from back pressure if the bladder is constantly full
• Chronic discomfort, pain, or a feeling of pressure in the pelvis

Long-term outlook

With the right treatment, most people with urinary retention experience significant improvement. The earlier you seek help, the better the outcome. Modern treatments – from simple lifestyle changes, medicine, gentle catheter use, to surgery – are very effective. Many people go on to lead normal lives with no ongoing problems.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.