Urinary Retention: Causes, Diagnosis & Treatment (2023)


Urinary Retention: Causes, Diagnosis & Treatment (1)

What is urinary retention?

Urinary retention is a condition where your bladder doesn’t empty all the way or at all when you urinate. Your bladder is like a storage tank for urine. Urine is made up of waste that’s filtered out of your blood by your kidneys. Once filtered, the urine moves to your bladder where it waits till it’s time to move through the urethra and out of the body.

When you have urinary retention, it can be acute (sudden) or chronic (long-term). Acute means that it comes on quickly and it could be severe. Chronic urinary retention means that you’ve had the condition for a longer period of time.

The acute form of urinary retention is an emergency. In this case, you’ll need to see a healthcare provider right away. The chronic form happens most of the time in older men, but it can also occur in women.

Symptoms and Causes

What causes chronic urinary retention?

Urinary retention can happen for several different reasons. These causes can include:

  • A blockage to the way urine leaves your body.
  • Medications you’re taking for other conditions.
  • Nerve issues that interrupt the way your brain and urinary system communicate.
  • Infections and swelling that prevent urine from leaving your body.
  • Complications and side effects of medications given to you for a surgical procedure.


When something blocks the free flow of urine through the bladder and urethra, you might experience urinary retention. The urethra is the tube that carries urine from the bladder to the outside of your body. In men, a blockage can be caused when the prostate gland gets so big that it presses on the urethra. This is the most common cause of chronic urinary retention in men. One cause in women is a bladder that sags. This is called cystocele. It can also be caused when the rectum sags into the back wall of the vagina – a condition called rectocele. Some causes can happen to both men and women. The urethra can get narrow due to scar tissue. This is called a stricture. Urinary stones can also block the flow of urine out of your body.


Urinary retention can also be caused by certain medications. Drugs like antihistamines (Benadryl®), antispasmodics (like Detrol®), opiates (like Vicodin®) and tricyclic antidepressants (like Elavil®) can change the way the bladder muscle works. Other medications can also cause bladder control side effects, including anticholinergics, some blood pressure-lowering medications, antipsychotics, hormonal agents and muscle relaxants.

Nerve issues

Passing your urine happens when the brain tells the bladder muscle to tighten. This squeezes urine from the bladder. The brain then tells the sphincter muscles surrounding the urethra to relax. This lets the flow of urine go through the urethra and out of the body. Anything that gets in the way on the path from the brain to the nerves that go to the bladder and the urethra can also cause this problem. Causes of nerve issues can include:

  • Stroke.
  • Diabetes.
  • Multiple sclerosis.
  • Trauma to the spine or pelvis.
  • Pressure on the spinal cord from tumors and a herniated disk.
  • Vaginal childbirth.

If you have had a thin tube called a catheter in the past, you may be at greater risk for this condition. Your risk is also higher if your healthcare provider has used any other special device on you, such as an ureteroscope or cystoscope (these are telescopes with cameras that look in the urinary tract).

Urinary retention from nerve disease occurs at the same rate in men and women.

Infections and swelling

In men, an infection of the prostate can cause it to swell. This causes it to press on the urethra to block the flow of urine. A urinary tract infection (UTI) can cause swelling of the urethra or weakness of the bladder, both of which can cause urinary retention. Diseases spread by having sex (called STIs) can also cause swelling and lead to retention.


Medicine given before and during surgery to make you sleepy may cause urinary retention right after surgery. Procedures such as hip replacement, spine surgery, rectal surgery, surgery for women’s pelvic issues, and surgery to remove hemorrhoids can cause the problem afterward.

What are the symptoms of urinary retention?

The signs can vary. Some people with the chronic form have a hard time starting the flow of urine. Some have a weak flow once they start. Others may feel the need to go but can’t start. Others have to go a lot, while others still feel the need to go right after going. You may “leak” urine when you aren’t going because the bladder is full.

With the acute form, you’re all of a sudden not able to go at all, or only able to go very small amounts. This occurs even though you have a full bladder. See a healthcare provider right away if this happens to you.

Diagnosis and Tests

How is chronic urinary retention diagnosed?

History and physical exam: During the diagnosis process, your healthcare provider will ask about your signs and symptoms and how long you have had them. He or she will also ask about your medical history and your drug use. A physical exam of the lower abdomen (belly) may show the cause or give your provider additional clues. After this, certain tests may be needed. Men may have a rectal exam to check the size of their prostate.

Your urine may be saved and checked to look for infection.

Ultrasound of the bladder: The amount of urine that stays in your bladder after urinating may be measured by doing an ultrasound test of the bladder. This test is called a postvoid residual or bladder scan.

Cystoscopy: Cystoscopy is a test in which a thin tube with a tiny camera on one end is put into your urethra. This lets the doctor look at pictures of the lining of your urethra and bladder. This test may show a stricture (scar) of the urethra, blockage caused by a stone, an enlarged prostate or a tumor. It can also be used to remove stones, if found. A computed tomography (CT) scan may also help find stones or anything else blocking the flow of urine.

Urodynamic testing: Tests that use a catheter to record pressure within the bladder may be done to tell how well the bladder empties. The rate at which urine flows can also be measured by such tests. This is called urodynamic testing.

EMG: Your healthcare provider may do certain tests if he or she thinks the retention is caused by a problem with the nerves. One test is electromyography (EMG). EMG uses sensors to measure electrical activity of muscles and nerves in and near the bladder and the urethral sphincter.

PSA: A prostate-specific antigen (PSA) blood test may be done as a screen for prostate cancer. If the PSA level is elevated, a transrectal ultrasound and maybe a biopsy of prostate tissue may also be done.

Management and Treatment

How is urinary retention treated?

Treatment for urinary retention can depend on whether you have the acute form or the chronic form, as well as the cause of the condition. For the acute form, a catheter is put into the urethra to drain the bladder.

Treatment of the chronic form – or the acute form that becomes chronic—will depend on the cause.

Medications for enlarged prostate: For men with an enlarged prostate, certain drugs may be used to try and open it up or shrink it. These include alpha-blockers (tamsulosin [Flomax®], terazosin [Hytrin®] and alfuzosin [Uroxatral®]) and 5-alpha reductase inhibitors (finasteride [Proscar®] and dutasteride [Avodart®]). Also, procedures or surgery to open up the prostate may be tried.

Procedures for enlarged prostate: Many procedures are available when this problem is due to an enlarged prostate. Office-based treatments can be done with just local anesthetic (numbing medicine) only. These include water vapor therapy (Rezum®) and prostatic urethral lift (Urolift®).

There are also several surgeries done under general anesthesia which are available. These include shaving down the inside of the prostate (transurethral resection of the prostate, or TURP) and opening up the prostate with a laser (Greenlight photoselective vaporization of the prostate, or PVP). A laser can also be used to carve out the entire enlarged portion of the prostate through the urethra (Holmium laser enucleation of the prostate, or HoLEP), or this part of the prostate can be removed through the belly (simple prostatectomy). All of these procedures can be effective in opening up the blockage.

Treatments for urethral stricture: For a urethral stricture, opening the scar tissue in the urethra with catheters and balloons may be tried. Surgery using a knife or laser that is moved through the urethra to make a cut to open the scar is also an option. Sometimes the scar tissue needs to be cut out and the urethra fixed with a surgery called a urethroplasty.

Treatment for nerve issues: If the retention is due to a nerve-related issue, you may need to use a catheter on yourself at home.

Treatments for women with urinary retention: For women with cystocele or rectocele as the cause, mild or moderate cases may be treated with exercises that strengthen the pelvic floor muscles. They also may be treated by putting in a ring called a vaginal pessary to support the bladder. Your provider may suggest estrogen therapy if you are past menopause. Surgery may be required for more severe cases to lift the sagging bladder or rectum.


What diagnosis causes urinary retention? ›

Urinalysis link is used to find medical conditions that may be causing urinary retention, such as a urinary tract infection (UTI), a kidney problem, or diabetes.

Will urinary retention go away? ›

Urinary retention can be a short-term or long-term problem and can occur suddenly (acute) or get worse over time (chronic). If urine stays in your bladder, it can lead to urinary incontinence (leaking urine between wees) and urinary tract infections.

What is the most common treatment for urinary retention? ›

Pelvic floor muscle exercises, also called Kegel exercises, help the nerves and muscles that you use to empty your bladder work better. Physical therapy can help you gain control over your urinary retention symptoms.

Does drinking more water help urinary retention? ›

In turn, the kidneys will only be able to make highly concentrated urine that irritates the bladder. Therefore, staying hydrated by drinking plenty of water throughout the day is one of the essential pieces of any treatment plan for urinary retention.

What diseases have urinary retention? ›

A urinary tract infection (UTI) can cause swelling of the urethra or weakness of the bladder, both of which can cause urinary retention. Diseases spread by having sex (called STIs) can also cause swelling and lead to retention.

Can bladder retention be fixed? ›

Treatment for urinary retention depends on the type of urinary retention you have—either acute or chronic—and the cause of your urinary retention. Treatments for urinary retention may include draining the bladder, medicines, medical procedures or devices, surgery, and self-care treatments.

What is the best medicine for urine flow? ›

Tamsulosin is in a class of medications called alpha blockers. It works by relaxing the muscles in the prostate and bladder so that urine can flow easily.

How serious is urinary retention? ›

Acute urinary retention can cause severe pain and be life threatening. If you are suddenly unable to urinate, it's important that you seek emergency medical treatment right away.

What does a urologist do for urinary retention? ›

There are several approaches to relieving urinary retention, including: Short or long-term catheterization. Medications designed to shrink an enlarged prostate (benign prostatic hyperplasia). In-office or surgical procedures to remove excess prostate tissue associated with BPH.

Do you need surgery for urinary retention? ›

Urinary retention at a glance

Acute urinary retention is a medical emergency and may involve complete inability to urinate and painful, urgent need to urinate. Surgical and other treatments are available to resolve urinary retention.

How can I empty my bladder without a catheter? ›

Leaning forward (and rocking) may promote urination. After you have finished passing urine, squeeze the pelvic floor to try to completely empty. not to promote bladder muscle instability with overuse of this technique. Tapping over the bladder may assist in triggering a contraction in some people.

Does walking help urinary retention? ›

Walking. Walking is a gentle exercise that can help stimulate peristaltic movement and prevent urinary retention and constipation (which can place an unnecessary strain on your bladder and cause overflow urinary incontinence).

Does cranberry juice help urine retention? ›

Cranberry juice helps fight off bladder infections, but it can be a culprit in worsening overactive bladder symptoms. The berries' acidity can irritate the bladder, and although its diuretic action helps flush out the bladder and urethra, it will also make you go more frequently.

Why am I retaining so much urine? ›

The causes of urinary retention are related to either a blockage that partially or fully prevents urine from leaving your bladder or urethra, or your bladder not being able to maintain a strong enough force to expel all the urine.

What are 2 complications from urinary retention? ›

Kidney damage — Sometime urinary retention can cause urine to flow back into the kidneys. This is called reflux and can damage or scar the kidneys. Urinary incontinence (after prostate, tumour, or cancer surgery) — Transurethral surgery to treat an enlarged prostate can result in urinary incontinence in some men.

What is the food can help to cure urine retention? ›

Bananas: Bananas are great as snacks and may also be used as toppings for cereals or in smoothies. Potatoes: Any type of potatoes are good for bladder health. Nuts: Almonds, cashews and peanuts are bladder friendly. They are also healthy snacks and rich in protein.

How do you unblock urine flow? ›

Passing a catheter in the bladder may be all that is needed to relieve the obstruction (a catheter is a soft tube that is inserted into the urethra). Medication can sometimes help if the obstruction is due to an infection, or sometimes in the case of an enlarged prostate.

What supplement increases urine flow? ›

Beta-sitosterol: This is a substance found in many plants. It doesn't affect the size of the prostate, but it may help your bladder empty and give you a stronger urine flow. It may improve other BPH symptoms as well.

What vitamin helps with bladder control? ›

A study done on vitamin c intake in 2060 women, aged 30-79 years of age found that high-dose intake of vitamin c and calcium were positively associated with urinary storage or incontinence, whereas vitamin C from foods and beverages were associated with decreased urinary urgency.

Who treats urinary retention? ›

A urologist is a medical doctor specializing in conditions that affect the urinary tract in men, women and children, and diseases that affect the reproductive system. These conditions range from peeing too much or too little to being unable to father a child.

How long do you need a catheter for urinary retention? ›

In general, the catheter stays in for 1-2 weeks. If the catheter is taken out early, the urethra will likely close again, you will be again unable to pee, and you will need to return to the ER to have another catheter inserted.

How can I stimulate my bladder to pee? ›

Using the fingertips, a person can gently but firmly tap the skin near the bladder every 30 seconds to encourage urination. Bending forward while sitting on the toilet puts additional pressure on the bladder, which can encourage urination. Placing a hand in warm water can trigger the urge to pee.

How do you clean your bladder? ›

Drink Plenty of Fluids to Flush Out Bacteria — But Don't Overdo It. Drinking plenty of water — six to eight glasses daily — can flush bacteria out of your urinary tract and help prevent bladder infections.

Can holding pee cause urinary retention? ›

When you hold your pee for 10 hours or more, you may develop urinary retention, meaning the muscles in your bladder can't relax and let you relieve yourself, even when you want to. In very rare cases, holding your pee can cause your bladder to burst.

What foods calm the bladder? ›

What foods calm the bladder? The American Urological Association also recognizes some foods as potentially having a calming effect on sensitive bladders. These foods include pears, bananas, green beans, squash, potatoes, lean proteins, whole grains, nuts, bread, and eggs.

Do Kegels help urinary retention? ›

Kegel exercises can prevent or control urinary incontinence and other pelvic floor problems. Here's a step-by-step guide to doing Kegel exercises correctly. Kegel exercises strengthen the pelvic floor muscles, which support the uterus, bladder, small intestine and rectum.

What is the best herb for urinary retention? ›

Dandelion. Dandelion is a wild herb known for its anti-inflammatory properties. It's been used historically to treat kidney disease and upset stomach. Because of its anti-inflammatory abilities, it's also been used to treat bladder inflammation and retention.

What is the best juice for urine retention? ›

We've all heard that cranberries and cranberry juice are great for bladder health – don't forget about the other tasty fruits and fruit juices that also help improve bladder function. Apples, bananas, berries (strawberries, blueberries), and pears are all healthy, filling snacks also high in fiber.

What neurological disorders cause urinary retention? ›

Common causes of neurogenic LUTS or LUTD include spinal cord injury, multiple sclerosis, Parkinson's disease, cerebrovascular accidents, cauda equina syndrome, diabetes mellitus, and multiple system atrophy.

What autoimmune disease causes urinary retention? ›

Interstitial cystitis (IC) is an autoimmune related condition that causes discomfort or pain in the bladder and a need to urinate frequently and urgently. It is far more common in women than in men. The symptoms vary from person to person. Some people may have pain without urgency or frequency.

What would cause a person not to be able to urinate? ›

Urinary retention can be caused by a problem with the nerves that control your bladder. This can happen as a result of diabetes, stroke, multiple sclerosis, brain or spinal cord infections or injuries, or pelvic injury.

What are the two types of urinary retention? ›

There are two general types of urinary retention: obstructive and non-obstructive.

What are 4 neurological conditions that cause problems with bladder control? ›

Nerve damage from conditions such as stroke, multiple sclerosis, spinal cord injury, or spina bifida can break down communication between the bladder and the brain. If you are diagnosed with a neurogenic bladder, seek help.

Which part of the brain controls urination? ›

The brainstem is located at the base of the skull. Within the brainstem is the pons, a specialized area that serves as a major relay center between the brain and the bladder (see the image below). The pons is responsible for coordinating the activities of the urinary sphincters and the bladder.

What cancers cause urinary retention? ›

Clinicians: look beyond prostate and bladder cancer

Bengtsen emphasized that “not only prostate cancer but also other urogenital, colorectal, and neurological cancers should be considered in older patients who present with their first acute urinary retention and no obvious underlying cause.”

Can vitamin deficiency cause urinary retention? ›

Incontinence, specifically the lack of the ability of the bladder to hold urine, is one of the major symptoms of vitamin B deficiency.

Is urinary retention a symptom of kidney disease? ›

Signs and symptoms of acute kidney failure may include: Decreased urine output, although occasionally urine output remains normal. Fluid retention, causing swelling in your legs, ankles or feet. Shortness of breath.

What are signs of urinary retention? ›

Chronic urinary retention symptoms include:
  • Frequent urination (more than 8 times per day)
  • Trouble starting urination.
  • Weak or intermittent urination stream.
  • A feeling of needing to urinate after finishing urination.

What happens to your body if you can't urinate? ›

Over time, you may develop incontinence. When you hold your pee for 10 hours or more, you may develop urinary retention, meaning the muscles in your bladder can't relax and let you relieve yourself, even when you want to. In very rare cases, holding your pee can cause your bladder to burst.

Is urinary retention permanent? ›

Chronic urinary retention — can be a long-lasting medical condition. People with chronic urinary retention can urinate, but they cannot completely empty all of the urine from their bladders.


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