Medical Treatment

You will probably have a Foley catheter inserted through your urethra into your bladder. This is a small, flexible rubber or silicone tube. Once it has reached your bladder, urine will drain out into a bag.

• The catheter can either be removed immediately or kept in place to provide continuous drainage.
  
  
• The decision to remove the catheter will depend on the amount of urine obtained and the likelihood that your symptoms will come back.
  
  
• The normal bladder capacity in adults is about a cup and a half (13.5 oz or 400 mL). If you retain much more urine than this, the catheter will be left in place to allow the bladder to contract to normal size.
  
  
• Sometimes when the retained urine is finally drained, it is bloody or slightly pinkish. This is usually minor and stops on its own in a short time. Your health care provider will monitor this to make sure it stops.

If a catheter cannot reach your bladder because of an obstruction in the urethra, an alternative procedure will be tried.

• The most common reason for the obstruction is a narrowing or stricture within the urethra.
  
  
• The catheter can be placed through your skin, over your pubic bone, and through the lower abdominal wall directly into your bladder. This is called the suprapubic route. The tube will provide temporary drainage until the situation can be managed via a cystoscopic procedure.
  
  
• Various dilators may be used to open the urethral channel wide enough to pass a catheter through.
  
  
• A urologist may do an immediate cystoscopy to insert the catheter under direct vision.

In the last few years, devices have become available that can help some people with chronic urinary retention. For example, an implantable device is available that stimulates the nerves that control the bladder.

• In some people, this helps the bladder relax and contract at the right times to allow urination.
  
  
• Talk to your primary care provider about whether this kind of treatment might work for you.