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Urinary retention

Difficulty emptying the bladder well or at all. To be able to urinate, the muscles surrounding the bladder must contract, the urethra must open and relax, and there should be a resulting free flow of urine. Urinary retention can occur if the bladder does not contract well enough, or at all, such as in neurogenic bladder or a bladder under the influence of certain medications. Urinary retention can also occur if the urethra does not relax during urination, or if the urethra is kinked off because of a prolapse, vaginal pessary or tampon. Urinary retention may be acute or chronic. Acute retention occurs when there is a sudden inability to empty the bladder. Chronic urinary retention usually happens over time. Patients with urinary retention may sense that they do not empty well, they may have urinary frequency or urgency, there may be a sense of a weaker stream, or there may not be any symptoms.

Diagnosis

A bladder sonogram can be done, or a urinary catheter may be inserted in the bladder, after attempted urination to determine the postvoid residual, or how much urine is left after urination. Other diagnostic procedures may include a cystoscopy or urodynamic testing.

Treatments for Urinary Retention

Treatment of urinary retention will depend on the cause. If a patient is taking a certain medication that may promote urinary retention, that medication will be discontinued. If there is a neurogenic bladder, the underlying condition may be addressed, or neuromodulation may be an option. If the patient has prolapse of the vaginal walls or some sort of obstruction, that prolapse can be reduced with a pessary or a surgery and the obstruction is removed. Regardless of the cause of urinary retention, a catheter can be used chronically or intermittently to make sure the bladder empties well.

Continuous Intermittent Self Catheterization

Using a small catheter to empty the bladder multiple times throughout the day.

Neuromodulation

A technology in which a stimulation is sent to the nerves responsible for controlling urinary urgency, urinary frequency, urge related urinary incontinence, fecal incontinence and urinary retention. There are currently two main forms of neuromodulation. These are Sacroneuromodulation and Tibial Nerve Stimulation.

  • Sacroneuromodulation – This form of neuromodulation involves placing a small wire attached to a small battery under the skin. The wire and battery are like a pacemaker and are placed in the hip pocket area. An electrical stimulation is sent from the wire to the area of the nerves that help control bladder and bowel function. You are given a remote that communicates with the battery so you can control the stimulation, turn it off and on and try various stimulation programs. This is a popular option for because the battery is replaced every 4-6 years and not many visits are required once your programs are set.
  • Tibial Nerve Stimulation – This form of neuromodulation is external. An acupuncture needle is gently inserted into the inside of the ankle. An external battery is then attached to the needle delivering a stimulation that gives a flutter sensation in the foot while the battery is connected. This energy is applied for 30 minutes. Since this option is not implanted, it requires repeat treatment weekly for twelve weeks and then monthly.
  • The information about urinary retention was reviewed by Dr. Maria Canter. If you have any questions, please don’t hesitate to contact us using our contact form below.

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