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Inability to Urinate (cont.)

What Exams and Tests Assess the Causes of Urinary Retention?

Medical evaluation for urinary retention includes a medical and physical examination (including a prostate examination in men) to find the cause of the problem.

On physical examination, the bladder may be palpable (be felt by the examiner).

A bladder scan (portable ultrasound-like evaluation) is often used to determine how much urine is in the bladder to confirm the diagnosis of urinary retention.

A catheter can be placed in the urethra. This is a thin, flexible tube. It goes up the bladder and drains the urine into a bag.

  • This is done both for diagnosis and as a treatment of the immediate problem. Draining urine almost always relieves the symptoms, at least for a while.
  • A urine sample will be taken to check for signs of infection, bladder irritation, stones, or other problems.

Other lab tests may be done, depending on your doctor's conclusions from your medical interview and exam.

  • Blood may be drawn to check for signs of infection, to check your kidney function, and levels of certain chemicals in your blood that may be altered if your kidneys are not working well, and possibly to rule out certain conditions.
  • The blood also may be checked for prostate-specific antigen (PSA). This is the same test used to screen men for prostate cancer.
  • A sample of the secretions from your penis (men) or vagina (women) may be checked for signs of infection as well.

If the doctor suspects an acute nerve problem causing urinary retention, a CT scan or MRI of the spine can be done for further evaluation.

People with chronic urinary retention or suspected bladder muscle weakness may be referred to a specialist in disorders of the urinary tract (urologist or urogynecologist).

  • The urologist may perform advanced urodynamic testing to see what is causing the problem. A urodynamic test is a specialized test used to determine bladder and urethral function. This study involves the placement of a catheter in the urethra, a separate small catheter in the rectum, and electrode patches on the outside area around the urethra and rectum. The bladder is filled with sterile fluid, and pressures within the bladder during filling and urination are measured. Use of contrast material (dye) allows the physician to take pictures during filling of the bladder and voiding, which may help evaluate other abnormalities. The electrode patches allow assessment of the function of the muscles that surround the urethra during bladder filling and urination.
  • If necessary, an ultrasound may be recommended to examine the upper urinary tract (the kidneys and ureters) to evaluate their size and examine for evidence of infection, stones, swelling of the kidneys, or other possible clues regarding the cause and duration of urinary retention.
  • The urologist also may recommend cystoscopy. A cystoscope is a thin, flexible tube with a tiny camera on the end. It is inserted through the urethra to examine the bladder, urethra, and prostate for abnormalities that can cause urinary retention.
Medically Reviewed by a Doctor on 10/27/2016
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