What happens with urinary retention
The bladder continues to fill, but cannot empty. Its wall stretches, the pressure inside increases and is transmitted upward to the ureters and kidneys. If the pressure persists for a long time, the kidneys stop removing waste products, and acute kidney damage develops.
The second mechanism of damage concerns the bubble itself. An overstretched muscle loses its ability to contract, and after removing the obstacle, a person may not urinate on his own for a long time. That is why we count by hours, not by days.
Chronic retention stands out separately: the bladder is not completely emptied, there is a lot of residual urine, but the person urinates and there is no pain. This condition is less dramatic, but no less dangerous for the kidneys and requires the same attention.
Reasons
- Prostate adenoma is the most common cause in men
- Prostate cancer
- Acute prostatitis with swelling of the gland
- Urethral stricture and bladder neck sclerosis
- A stone wedged into the urethra or neck of the bladder
- Blood clots blocking the outlet - bladder tamponade
- Phimosis and paraphimosis
- Neurogenic causes: spinal cord injury, disc herniation, multiple sclerosis, diabetic neuropathy
- Postoperative delay after anesthesia and surgery on the pelvic organs
- Medicines: some cold and allergy remedies, antispasmodics, antidepressants, painkillers
- Alcohol combined with prolonged urinary retention
- In women - pronounced prolapse of the pelvic organs, space-occupying formations, postpartum delay
- Constipation with rectal fullness
What to do and what not to do
- Обратиться за медицинской помощью немедленно — мочу нужно вывести
- Не пить много жидкости в надежде «протолкнуть» мочу: пузырь уже переполнен
- Не принимать мочегонные
- Не пытаться самостоятельно вводить катетер — это ведёт к травме уретры и кровотечению
- Горячая ванна иногда помогает при спазме, но не при механическом препятствии, и не должна становиться поводом откладывать обращение
- Взять с собой список принимаемых препаратов — часто именно они запустили эпизод
How help is provided
- Bladder catheterization is the main way to quickly remove urine
- Slow emptying with a large volume to avoid a sharp drop in pressure and bleeding from dilated veins
- Trocar cystostomy - installation of drainage above the pubis, if it is impossible to pass a catheter through the urethra (stricture, large adenoma, trauma)
- Epicystostomy - open fistula in difficult situations
- Optical urethrotomy for stricture
- Washing out clots during bladder tamponade
- Monitoring diuresis and blood biochemistry after resolution of the delay - a phase of heavy urination is possible
What to do after the urine has been removed
Removing urine removes the threat, but does not solve the problem: without eliminating the cause, the episode will repeat, often within a few days.
- Ultrasound of the bladder, prostate and kidneys with determination of residual urine
- Creatinine and blood electrolytes
- PSA - but not in the first days after catheterization, since the result will be overestimated
- General analysis and urine culture
- Uroflowmetry after restoration of spontaneous urination
- Urethrography for suspected stricture
- Cystoscopy according to indications
- Review of medications taken
- Planned treatment of the cause: medications for adenoma, TUR of the prostate or HoLEP, urethroplasty for stricture
Prevention of a recurrent episode
- Treatment of prostate adenoma and regular monitoring by a urologist after 45–50 years
- Don't tolerate a full bladder
- Be careful with cold, allergy, and antispasmodics for BPH
- Moderation with alcohol, especially in combination with prolonged urinary retention
- Treatment of constipation
- Monitoring residual urine by ultrasound for known adenoma
- Timely treatment of urethral stricture and urinary tract infections
Where to contact in Tashkent
Urinary retention requires round-the-clock urological care: catheterization or cystostomy, followed by examination and routine elimination of the cause.
In Tashkent, such care is provided at the UROLOGIC COMPLEX medical center and at the Tashkent Medical Park clinic - here you can also undergo examination and surgical treatment of prostate adenoma or urethral stricture, which are most often behind an episode of retention.
If urinary retention occurs for the first time, be sure to follow through: finding out and eliminating the cause is more important than simply relieving an acute condition. Clinic contacts are below on the page.
