What Should Seniors Know About Urinary Retention?
Urinary retention, the inability to completely empty the bladder, affects many seniors and can become a medical emergency. Understanding this condition helps seniors recognize symptoms and seek appropriate care.
Understanding Urinary Retention
Urinary retention occurs when the bladder cannot empty completely or at all. Acute retention is sudden inability to urinate despite a full bladder, a medical emergency. Chronic retention develops gradually, with incomplete emptying leaving residual urine.
The bladder normally stores urine until convenient to void, then contracts to expel urine while the sphincter relaxes. Retention occurs when this coordinated process fails due to obstruction, weak bladder muscle, or nerve problems.
Causes in Seniors
Benign prostatic hyperplasia is the most common cause in men. The enlarged prostate compresses the urethra, obstructing flow. As BPH progresses, retention risk increases.
Medications commonly contribute to retention. Antihistamines, decongestants, antidepressants, antipsychotics, and many other medications affect bladder function. Anesthesia and pain medications after surgery frequently cause temporary retention.
Constipation can cause retention. A full rectum presses on the bladder and urethra. Severe constipation may precipitate acute retention.
Neurological conditions including stroke, Parkinson’s disease, multiple sclerosis, and diabetic neuropathy affect bladder nerve control. These conditions can cause retention or other bladder dysfunction.
Pelvic organ prolapse in women can obstruct the urethra. Bladder, uterine, or rectal prolapse may mechanically prevent complete emptying.
Symptoms
Acute retention causes inability to urinate despite strong urge, lower abdominal pain and distention, and significant discomfort. This is a medical emergency requiring immediate catheterization.
Chronic retention symptoms are subtler. Weak urine stream, difficulty starting urination, frequent urination of small amounts, feeling of incomplete emptying, and dribbling after urination suggest chronic retention. Recurrent urinary tract infections may result from residual urine.
Complications
Urinary tract infections occur when residual urine provides a breeding ground for bacteria. Recurrent UTIs should prompt evaluation for retention.
Bladder damage can result from chronic overdistension. The stretched bladder muscle may lose ability to contract effectively. Prolonged retention can cause permanent bladder dysfunction.
Kidney damage may occur if retention backs up urine into the kidneys. Hydronephrosis, kidney swelling from backed-up urine, can impair kidney function.
Treatment
Acute retention requires immediate catheterization to drain the bladder. This provides immediate relief and prevents complications. Further evaluation determines the cause and ongoing treatment.
Chronic retention treatment depends on the cause. Medications for BPH can improve flow. Stopping or changing causative medications helps. Surgery may be needed for obstruction. Intermittent self-catheterization manages retention that cannot be otherwise resolved.
Getting Urinary Retention Care
All Seniors Foundation encourages evaluation of urinary symptoms that might indicate retention. Proper diagnosis enables effective treatment. Contact us if you have difficulty urinating or symptoms suggesting retention.
