Synonyms
Urinary retention is the inability to urinate even though the bladder is full. The clinical picture “urinary retention” is a urological emergency. The incidence of urinary retention is 14 per 100 000 inhabitants per year.
Can be responsible for urinary retention: Obstructions that cause urinary retention can be caused by changes in the prostate (prostate gland), such as prostate enlargement (hyperplasia), prostate abscess (inflammatory tissue fusion with pus formation) or prostate cancer (carcinoma). Since the prostate surrounds the urethra, which conducts urine from the bladder to the outside, this flow path is constricted in the case of the above-mentioned changes, resulting in a congestion with urinary retention. Diseases of the urethra itself can also result in such an obstruction with subsequent urinary retention.
These include urethral stricture, urethral cancer or urethral diverticula (bulging of the mucous membrane). Furthermore, such a mechanical obstruction can also be caused by a bladder stone. Trauma resulting in urinary retention can affect the urethra or the bladder.
A rupture of the urethra, which subsequently interrupts the flow of urine, or a so-called bladder tamponade are examples of trauma with subsequent urinary retention. A bladder tamponade is a massive bleeding in the bladder with formation of blood clots and urinary retention. Furthermore, urinary retention can have a neurogenic cause, i.e. the reason lies in changes in the nervous system.
Examples of this are a herniated disc in the lumbar spine, whereby the disc compresses the nerves that control the bladder and sphincter muscle function and thus prevents adequate bladder emptying. In cases of multiple sclerosis (MS), herpes zoster virus infection or borreliosis, corresponding nerves can also be damaged, so that urinary retention occurs. In addition, a so-called spinal shock leads to neurogenic urinary retention.
In this case, a nervous failure leads to circulatory insufficiency and in the course of this to urinary retention. Another reason for urinary retention can be certain drugs. These include antiallergics (drugs for the treatment of allergic reactions), analgesics (painkillers), drugs for the treatment of Parkinson’s disease, anaesthetics (narcotics) or antiarrhythmics (drugs for cardiac arrhythmia).
Gynecological diseases can also cause urinary retention. Examples are a prolapse of the uterus and vagina (Descensus uteri et vaginae; uterus = uterus, vagina = vagina), because these organs compress the urethra from the outside. As a result, the flow of urine is impaired, and urinary retention occurs.
In addition, iatrogenic reasons must also be mentioned. Certain surgical procedures near the bladder may cause a reflex urinary retention. Finally, there are psychogenic reasons that cause urinary retention.
Psychogenic reasons include the patient being unable to empty his bladder, for example out of shame.
- Mechanical obstruction (constriction) below the bladder
- Trauma
- Insufficient neurogenic function of the bladder or bladder sphincter
- Drugs
- Gynecological changes
- Medical interventions and their consequences (iatrogenic cause)
- Psyche
Patients who suffer from urinary retention complain of a strong urge to urinate, but at the same time are unable to empty their bladder (leading symptom). Furthermore, the filled bladder may be visible as a swelling in the lower abdomen, patients are pale, restless and sweating. However, if the cause of urinary retention is neurogenic, the pain may be absent.
