Do you find it difficult to empty your bladder every time you visit the toilet? If you are unable to urinate even though the urine has accumulated and the bladder is full, then you are probably suffering from urinary retention. In addition to not being able to relieve yourself and constantly feeling full in your bladder, if the urine is not drained, it backs up into the kidneys. As a result, the kidneys can become so full of urine that they swell and begin to press on the surrounding organs.
Urinary retention can occur in patients of both females and males, however men are more susceptible, especially as they get older.
Acute or Chronic Urinary Retention?
In acute urinary retention we have strong symptoms with pain and a feeling of bladder fullness. The feeling of needing to urinate is very urgent but the patient is unable to urinate.
Conversely, in the case of chronic retention, the urine is drained but by half or less. Thus, the bladder remains partially full even after urination. As a result, even 2 liters of urine are accumulated in the long-term. It is important to know that chronic urinary retention is not immediately noticed by the patient, since it is usually painless and asymptomatic. It may take time for the patient to notice symptoms.
Symptoms of chronic urinary retention include pain during urination, low urine flow, with hesitancy at the start, as well as a feeling of fullness immediately after urination. Incontinence or light incontinence (loss of urine when coughing or sneezing) is also often observed.
What Are the Causes of Urinary Retention?
The problem is essentially the inability to expel urine, usually due to a blockage of the urethra and in particular of the bladder outlet tube. An overfilled bladder presses on the urethra, creating pain and discomfort low in the pelvis. There are many reasons that can cause urinary retention.
Through our experience and research carried out in the field, we have collected the following cases:
- For men over 40 years of age, prostate enlargement. An increase in the size of the prostate gland leads to a blockage of the urethra and, by extension, of the bladder.
- For women, pelvic organ prolapse which blocks the urethra. This condition usually results from loosening of the pelvic muscles. The main reason for this loosening is childbirth. Also, during pregnancy, acute urinary retention is a rare but possible complication. The main causes are the pressure exerted by the enlarged uterus and the appearance of fibroids.
- In both sexes, but more so in men, a stricture of the urethra can occur. In the stricture, the diameter of the urethra decreases so that it is not possible to expel urine.
- Kidney stones and foreign bodies (if not removed in a short period of time) also cause urinary retention in the long term.
- After surgery: In cases of surgeries with general or spinal anesthesia. Immediately after the operation and for some hours afterwards, patients cannot urinate even if they feel the need to do it so due to the effect of the anesthesia.
- Finally, patients with chronic diseases such as diabetes, multiple sclerosis, bone marrow diseases, Parkinson's disease as well as a stroke can cause neurological problems which leads to malfunctioning of the bladder.
Treatment
The sulution to relieving urinary retention is found in the insertion a catheter to allow the urine to pass and relieve the feeling of a constantly full bladder.
Which is the Right Catheter for Me?
Your doctor will decide whether the catheterization will be done using an intermittent catheter or an indwelling Foley catheter.
In contrast to the permanent, the intermittent catheterization is done at regular intervals, since the specific catheters are disposable. With proper training from your nurse, you can do catheter changes at home by yourself or with the help of a relative. Intermittent catheterization can be done periodically, especially in cases of chronic neurological diseases.
Intermittent catheterization for women is done using B braun's Actreen Mini Cath and for men with Actreen Hi-Lite Cath Nelaton.
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In case of urethral stricture, the appropriate solution is Tieman. The suprapubic catheter is also used in patients with stenosis which is placed from the abdomen. Transpubic catheterization, unlike intermittent catheterization, should be performed by a qualified healthcare professional.
In case of urethral stricture, the appropriate solution is Actreen Hi-Lite Cath Tiemann. Also, in patients with stenosis, the suprapubic catheter is used, which is placed from the abdomen.
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Unlike intermittent catheterization, transpubic catheteriazation should be performed by a qualified healthcare professional.
Catheterization is the immediate solution to relieve the persistent symptoms of urinary retention. Of course, urinary retention is a symptom of some disease or chronic condition. So, long-term treatment will focus on this primary problem either with medication (painkillers, antibiotics) or with surgery (eg. in the case of prostate enlargement).
Things I can do to help me urinate!
When you notice difficulty urinating or a change in urine flow (less flow), you can fill a bathtub with warm water and try urinating there. Alternatively, you can put your hand in hot or cold water, ideally while you are already sitting on the toilet. It will help if the sink is close to the toilet bowl. The position in which you sit to the toilet, is also very important. toilet! For example, when you bend forward, you increase the pressure on the bladder. This will make it easier to urinate.
If you believe that the difficulty you are experiencing is due to any medication you are taking, contact your doctor or nurse immediately!
Source: https://www.healthdirect.gov.au/urinary-retention