Inability to Urinate or Urinary Retention
Pelvis | Urology | Inability to Urinate or Urinary Retention (Symptom)
Urinary retention occurs when a person cannot empty his or her bladder completely, or at all, despite an urge to urinate. Urinary retention can be an acute (new, short-term) or chronic (ongoing, long-term) condition. It routinely requires medical attention, sometimes hospitalization, for treatment, symptom relief, and detection of the underlying cause.
The two essential causes of urinary retention are (1) blockage of the urethra and (2) disruption of the delicate and complex system of nerves that connects the urinary tract with the brain and the nervous system.
The most common cause of blockage of the urethra in men is enlargement of the prostate. In males, the prostate gland partially surrounds the urethra. If the prostate becomes enlarged, which is common in older men, it presses on the urethra and can block it. The most common cause of prostate enlargement is benign prostatic hypertrophy (often called BPH). Other causes of prostate enlargement include prostate cancer and prostate infection (prostatitis). Causes of blockage of the urethra that can occur in both sexes include scar tissue, injury (as in a car wreck or bad fall), blood clots, infection, tumors in the pelvic region, and stones (rare).
Disruption of the nerves between the bladder and the brain can cause lose of control of the bladder function. The problem may lie in the nerves that send messages back and forth or in the nerves that control the muscles used in urination, or both. Some forms of this condition are referred to as neurogenic bladder. Occasionally, urinary retention is the first sign of spinal cord compression, a medical emergency that must be treated right away to prevent permanent, serious disability. The most common causes of this disruption include spinal cord injury, spinal cord tumour, strokes, diabetes mellitus, herniated or ruptured disk in the vertebral column of the back, or an infection or blood clot that places pressure on your spinal cord.
An infection in the pelvic area, such as herpes, can interfere with nerves in the area. Inflammation and swelling caused by infections can also compress the urethra. Infections around the spinal cord can cause retention by placing pressure on the nerves of the spinal cord.
Urinary retention is a relatively common problem after surgery. It can be a direct result of the anesthetic or the type of operation. Relative immobility after a surgery can also contribute to urinary retention. Previous bladder or prostate surgeries can sometimes cause urinary retention because of the formation of strictures (narrowing) due to scar tissue.