Men more than women sometimes develop acute urinary retention. The sudden inability to pass urine usually presents in older individuals and can be very distressing.
Acute urinary retention can occur in anyone and at any age. However data from hospitals reveals that men are more prone to acute urinary retention after the 6th decade of life.
Risk factors
Acute urinary retention does not occur in everyone and sometimes it is possible to predict in whom the disorder may occur. The risk factors for acute urinary retention include a history of kidney stones, having prostate cancer, prostatitis (infection of prostate) and benign prostatic hypertrophy (BPH). Women also develop acute urinary retention and it occurs most often in females with urinary tract infections, during pregnancy and those who have had recent gynecological surgery.
Causes
In acute urinary retention the urine collected in the bladder fails to come out. One may feel sensations of a full bladder and the urge to urinate, but the urine won’t flow. Causes of acute urinary retention include:
Excessive alcohol consumption
Use of medications like anti histamines, decongestants, certain bronchodilators, anti parkinsonian drugs, anti cholinergics, medications for blood pressure, anti depressants
Prolonged periods of bed rest
Exposure to intense cold
Spinal cord trauma or paralysis
Recent surgery or anesthesia
Presence of a urinary tract infection
Benign prostatic hypertrophy
Symptoms
Acute urinary retention is very unpleasant and presents with sudden lower abdominal pain, distended lower abdomen and inability to void urine. Most individuals will writhe in pain, be extremely anxious, may develop profuse sweating and become restless.
Diagnosis
The diagnosis of acute urinary retention is made by the clinical presentation and history. No radiological tests are required to make the diagnosis of this acute disorder. Investigations are generally done after treatment.
Treatment
To avoid developing complications, acute urinary retention must be treated within 4-6 hours after onset of symptoms. The most effective treatment for acute urinary retention is inserting a small catheter into the bladder. These catheters come in various sizes and shapes and immediately provide relief. These small flexible catheters must be inserted sterilely and the procedure can be done at the bedside.
Once relief is obtained, studies are done to determine the cause. Urine analysis is always done to determine the presence of an infection. Other tests include a bladder scan, abdominal X rays, rectal exam, urodynamic studies and cystoscopy.
Prognosis
If the urinary retention was due to a drug or anesthesia, then you will be able to pass urine once the catheter is removed. However, depending on the cause more than ¾ of cases of acute urinary retention recur within a week. Thus, most physicians leave the catheter until investigations are completed. In men, the most common causes of acute unary retention is BPH. Individuals who have BPH will need some type of procedure to relieve the obstruction and prevent acute retention of urine. Surgery for BPH may cause a temporary loss of libido and incontinence of urine, but these problems are temporary. Most men regain normal sexual and bladder function within 6-12 months.
Complications
when acute urinary retention is not treated promptly it can lead to bladder damage and kidney failure.