Urinary retention - Causes and Symptoms

Definition

Urinary retention is the inability to completely empty the bladder, due to obstacles that are interposed on the flow path.

Acute or chronic, urinary retention manifests itself with the impossibility of eliminating urine, despite the urination stimulus being present and ever more intense.

Urinary retention is not necessarily accompanied by pain (especially when it develops slowly), but may be due to suprapubic distension (bladder globe) detectable by palpation (or percussion) and uncontrollable drip of urine. Some people report having weak urine flow with frequent interruptions, an increase in voiding frequency (especially at night) and a difficulty in starting to urinate.

Urinary retention is often a complication of urogenital or neurological diseases; the disorder is more frequent with increasing age, especially among men, in whom prostatic pathologies or urethral strictures cause obstruction to the flow of urine. The most common causes are prostate hypertrophy and carcinoma, bladder stones and vaginal prolapse.

Urinary retention may be due to drugs (including anticholinergics, antihypertensives, antispasmodics, sedatives, opioids and non-steroidal anti-inflammatory drugs), stones that partially occlude the urethra, traumas of the lower abdomen and severe fecal stasis (which increases pressure on the bladder trigon). ). Furthermore, it can be a consequence of neurological bladder in patients with diabetes, multiple sclerosis, Parkinson's disease or previous pelvic surgery with bladder denervation.

Possible causes also include reduced bladder contractility and a loss of normal coordination between bladder detrusor contraction and sphincter relaxation.

Long-term urinary retention predisposes to urinary tract infections caused by urine stagnation and, over time, may impair renal function.