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Inability to Urinate (cont.)

Are There Home Remedies for Urinary Retention?

Acute urinary retention requires immediate drainage for relief and thus a visit to your health-care provider or a hospital emergency department. You can try very limited care at home, but do not delay medical evaluation if you are in pain. Try sitting in a bathtub full of warm water to relax the pelvic floor muscles or running the water in the bathroom to stimulate the flow of urine.

Discuss your prescribed medications, as well as any over-the-counter medications that you may be taking with your doctor, to determine if one or more of your medications may be affecting your ability to urinate normally.

People with limited mobility (for example, after a medical illness or a surgery with prolonged recovery period) resulting in an inability to urinate can be encouraged to get up and walk, as this increased activity may facilitate urination.

Management of constipation with fiber supplements, stool softeners, and laxatives as recommended by your doctor may be helpful.

What Is the Treatment for an Inability to Urinate?

If urinary retention is thought to be acute, severe, or painful, a Foley catheter may be inserted through the urethra into the bladder. This is a small, flexible rubber or silicone tube. Once it has reached the bladder, urine will drain out into a bag and the balloon is inflated to keep the catheter in place.

  • 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, the cause, and the likelihood that your troubles urinating will come back.
  • The normal bladder capacity in adults is about a cup and a half (13.5 oz or 400 ml). If much more urine than this is retained, the catheter may be left in place to allow the bladder to contract to its 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 physician will monitor this to make sure it stops.
  • The urologist/urogynecologist may recommend clean intermittent catheterization/self-catheterization (CIC) for the short or long term while the physician determines the cause and best form of treatment for the urinary retention. In some cases, if the bladder is no longer functioning adequately, long-term self-catheterization is performed. Self-catheterization involves placing a small catheter through the urethra into the bladder to empty the urine and then removing the catheter at set intervals each day. In those individuals who can urinate some on their own, this is typically performed after urination to ensure that the bladder is completely emptied. The use of a lubricating jelly and/or special lubricated catheters makes the procedure less uncomfortable. Nurses in the clinic often can teach patients how to perform CIC.

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

  • The most common reason for the obstruction is a narrowing or stricture within the urethra. In this setting, a cystoscopy can often identify the area of narrowing, and a small wire can be passed through the narrowed area, and the area can be dilated with special dilators that pass over the wire and a catheter placed.
  • In the situation in which a catheter cannot be placed through 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. This procedure is generally performed by urologists. The tube will provide temporary drainage until the situation can be managed via a cystoscopic procedure.

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. These devices are typically placed by a urologist and/or urogynecologist for select indications.

Medically Reviewed by a Doctor on 11/21/2017
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