Overview
What is it?
This is where a man finds it difficult to pass urine. There are two different types of urinary retention – acute, where the ability to pass urine stops completely and this becomes a medical emergency, and chronic, which is where it happens more gradually and the volume slowly reduces.
Causes
There are a number of potential causes of urinary retention:
- Benign Prostatic Hyperplasia
- A blockage, where the prostate gland becomes enlarged and puts pressure on the urethra
- Infection and swelling – if a prostate infection causes it to swell, then again pressure can be placed upon the urethra
- Urinary strictures
- Nerve causes – such as stroke or diabetes
- Past catheterisation
- Drugs such as antihistamines or antidepressants, as these can affect the bladder muscle
Treatment
Where a patient has acute retention, catheterisation will be required immediately.
For patients with chronic retention, they may still need a catheter but this may not be a long-term solution, unless the retention is persistent. There can be side effects of long-term catheterisation as well.
If men have moderate or sever symptoms, they may be recommended an alpha-adrenoceptor blocker, which relaxes the muscle.
Benign Prostatic Hyperplasia
For patients with BPH, there are a few options that will depend on their symptoms:
- Monitoring – if symptoms are not problematic or there are no complications of BPH, this may be the best course of action
- Alpha-adrenoceptor blocker – this should increase the urinary flow rate
- 5α-reductase inhibitor – suitable for men with an enlarged prostate, a raised PSA or a risk of progression. It can be used in combination with an alpha-adrenoceptor blocker
- Surgery – appropriate for patients with more severe symptoms, those who do not respond to drugs or if there are complications
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