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Acute Urinary Retention

Acute urinary retention (i.e., the sudden inability to urinate) is usually symptomatic of another condition that requires treatment.

Incidence and Prevalence
Anyone can experience acute urinary retention. The causes and rate of occurrence varies greatly between genders. At about the age of 60, men are more often affected as a result of benign prostatic hyperplasia (BPH).

Risk Factors

Kidney stones, prostate cancer, prostatitis, and BPH are risk factors in men. Women with a history of kidney stones or urinary tract infections (UTIs), pregnant women, and those who have had recent gynecological surgery are at higher risk.

Causes

Acute urinary retention may be caused by obstruction in the bladder or in the tube that carries urine from the bladder outside the body (urethra), by a disruption of sensory information in the nervous system (e.g., spinal cord or nerve damage), or by distention (swelling) of the bladder (e.g., by delaying urination for a long period of time).

Factors associated with acute urinary retention include the following:

• Alcohol consumption
• Allergy or cold medications containing decongestants or antihistamines
• Certain prescription drugs (e.g., ipratropium bromide, albuterol, epinephrine) that cause the urethra to narrow
• Delaying urination for a long time
• Long period of inactivity or bed rest
• Prolonged exposure to cold temperatures
• Spinal cord injury/nerve damage
• Surgery (e.g., complication of anesthesia)
• Urinary system obstruction (e.g., BPH, kidney stones)
• Urinary tract infection

Signs and Symptoms

Acute urinary retention produces severe lower abdominal pain, a distended abdomen, and/or the sudden inability to pass urine.

Complications that may develop with untreated urinary retention include bladder damage and chronic kidney failure.

Diagnosis

Diagnosis is based on a sudden lack of urinary output and bladder swelling (distention) observed during a physical examination.

Treatment

To avoid complications, treatment should be obtained within 5 hours of the onset of symptoms. The underlying cause of urinary retention (e.g., kidney stones) must be diagnosed and treated as well.

Treatment involves inserting a small tube (catheter) into the bladder through the urethra to drain the urine. Catheterization relieves pain and distention.

Prognosis

Depending on the underlying cause, as many as 70% of acute urinary retention cases recur within a week after initial treatment. BPH causes most recurrences.

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