Do you also have difficulty urinating? Let's learn about urinary retention

Do you sometimes feel like you have to stop halfway through your urination , or that your bladder hasn't completely emptied? Or do you have difficulty starting to urinate ? This is a common health problem that many people are embarrassed to talk about, but it can be a very important health problem. Today we are talking about this condition called urinary retention, or medically known as ``Urinary Retention''. Don't worry, this is something that can be controlled if understood and treated properly.

Simply put, what is urinary retention?

Think of your bladder as a water tank. Our kidneys filter the waste products from our bodies and produce urine (pee/urine) that collects in this bladder. When we need to urinate, the urine leaves this tank through a tube called the urethra.

Urinary retention is when your bladder doesn't empty completely when you urinate. Sometimes there may be a little left over, and in more severe cases, you may not be able to urinate at all.

There are two main types of this.

This urinary retention condition can occur in two main ways. The symptoms and severity of each vary.

1. Acute Urinary Retention: This is a sudden , sudden condition. You feel the need to urinate, but you are unable to urinate even a little. This may be accompanied by severe pain in the lower abdomen. This is a medical emergency. If this happens, you should go to the emergency room (ETU) of a hospital immediately.

2. Chronic Urinary Retention: This is a condition that develops gradually over time. You can urinate, but your bladder does not empty completely. Most of the time, the symptoms are not severe, so some people may not pay much attention to it. However, it is still important to get treatment for this condition.

What are the symptoms of this condition?

Let's now look at the symptoms that can be seen in these two types. It will be very important for you to know how to clearly distinguish between these.

Why does urine get stuck like this? What are the main causes?

There are several reasons why urine retention can occur. Let's discuss the main reasons separately.

1. Urinary tract obstruction (Blockage)

Simply put, there is an obstruction in the path of urine flow. Just like when you squeeze a water pipe, the water flow decreases. The main reason for this is the enlargement of the prostate gland in men (Enlarged Prostate or Benign Prostatic Hyperplasia - BPH) . Since this gland is located around the urethra, when it enlarges, it tightens the urethra and blocks the path of urine.

Additionally:

• Urinary tract stones, blood clots, or cancer.
• Narrowing of the urethra due to scar tissue (Urethral Stricture) .
• Cystocele (prolapse of the bladder into the vagina) in women.
• Rectocele (protrusion of the rectum into the vaginal wall) in women.

2. Some medications

Some medications you take for other conditions can also cause urinary retention. For example, some allergy medications (Antihistamines), some pain relievers (Opiates), and some antidepressants (Tricyclic Antidepressants) can affect the way your bladder muscles work.

3. Nerve Issues

The brain gives us the signal to urinate. The brain tells the muscles in the bladder to tighten and the muscles around the urethra to relax. If there is any damage to the nerve connections between the brain and the urinary system, the process of urination can be disrupted.

Things that can cause this:

• Stroke
• Diabetes (Diabetes Mellitus)
• Diseases affecting the nervous system (e.g. Multiple Sclerosis)
• Injuries to the spine or pelvic area
• Childbirth
• Pelvic surgeries

4. Infections or Swelling

Swelling caused by a urinary tract infection (UTI) , prostate infection (prostatitis) , or sexually transmitted infections (STIs) can also block the passage of urine.

5. Surgery

Temporary urinary retention can occur, especially after major surgery such as hip replacement or after anesthesia is administered.

What can happen if you don't take care of urinary retention?

It's not a good idea to just ignore this as something else, because if chronic urinary retention is not treated, it can lead to other complications.

• Urinary tract infections (UTIs): When urine stays in the bladder for too long, bacteria are more likely to grow. These infections can even travel up to the kidneys.
• Bladder damage: Because it is constantly full, the bladder muscles can become stretched, weakened, and damaged.
• Kidney damage: Infections or excessive pressure in the bladder can damage the kidneys and cause kidney disease.
• Bladder Stones: When urine accumulates in one place, the minerals in it can accumulate and form stones.

How do you find this, Doctor?

If you have these symptoms, the first thing to do is see a doctor. It's best to see a doctor who specializes in diseases of the urinary system (urologist).

By the doctor:

• You will be asked about your symptoms and how long they have been present.
• Ask about your complete medical history.
• Does a physical examination.
• A urine sample is tested to see if there is an infection.
• If you are a man, you can have a digital rectal exam to check the prostate gland.

In addition, further tests may be performed to determine the exact cause.

• Post-void residual (PVR) test: This measures how much urine is left in the bladder after you finish urinating.
• Cystoscopy: A tube with a small camera is passed down the urethra to examine the inside of the bladder and urethra.
• Urodynamic testing: A series of tests that measure the function and pressure of the bladder and surrounding muscles.
• PSA test: A blood test to check for prostate cancer risk.

What are the treatments for this?

Treatment methods depend on whether you have acute or chronic pain and what the cause is.

Treatment for acute urinary retention

Since this is an emergency, the first thing to do is to insert a catheter and drain the urine from the bladder. This will provide immediate relief. Only then can the cause be identified and treated.

Treatment for chronic urinary retention

There are several treatment options for this.

• Medication: If the prostate is enlarged, medication may be given to shrink it or relax the muscles around it. Antibiotics may be given for infections.
• Surgery: Depending on the cause, surgery may be necessary. This may include removing the prostate gland (TURP), repairing a blockage in the urethra (Urethroplasty), or surgically correcting a cystocele/rectocele.
• Nonsurgical treatments:
• Kegel exercises: Exercises that strengthen the muscles in the pelvic area.
• Vaginal Pessary: ​​A device that is placed in the vagina to support a prolapsed bladder.
• Bladder control: Behavioral changes such as controlling when to drink fluids.

Some people with neurological disorders are taught by their doctor how to self-catheterize themselves at home using a catheter.

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