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Inability to Urinate (cont.)

Is Surgery Needed for Urinary Retention?

Depending on the cause of the urinary retention, surgery may be indicated to help resolve the urinary retention. Surgery is commonly performed for urethral strictures, bladder stones, enlarged prostate, bladder prolapse, certain neurologic conditions, pelvic tumors, and other conditions. Whether or not you gain the ability to completely empty your bladder after surgery will depend to some extent on the function of your bladder and its ability to improve function after the blockage is relieved.

Is It Possible to Prevent Urinary Retention?

Good urination habits are essential to keep the bladder functioning normally. Most people normally urinate four to six times per day. Frequent holding of urination for prolonged periods can weaken bladder muscles because of overstretching. This may not seem like a problem initially, but over the course of 20-30 years, it can cause urination problems. Excess alcohol intake may lead to increased urine production and overdistention of the bladder. Lastly, over-the-counter cold medications containing antihistamines and pseudoephedrine (and other medications like it) can increase the risk of urinary retention in men with prostate enlargement.

What Is the Prognosis for an Inability to Urinate?

The prognosis depends on the source of the problem.

  • People with urinary retention caused by obstruction, infection, drugs, or the postoperative state generally recover much more easily than those with a nerve problem. The time frame for recovery varies, however.
  • People who continue to have urinary retention despite treatment may need long-term therapy. The best option for long-term therapy is clean, intermittent catheterization/self-catheterization.
  • You or your caregiver can be taught how to insert a removable catheter into the bladder to allow urine to drain.
  • Catheterization can either be a temporary measure until normal urination returns or be more permanent.
  • The other option is placing a Foley catheter into the bladder either via the urethra or through the skin. Tubes will be changed monthly to limit the risk of infection.
  • Clean, intermittent catheterization/self-catheterization also remains a treatment option for people who are having troubles urinating over the long term and/or are unable to urinate at all after a trial of an indwelling catheter.

REFERENCES:

Deters, Levi A. "Benign Prostatic Hypertrophy." Medscape.com. Sept. 21, 2016. <http://emedicine.medscape.com/article/437359-overview>.

Negro, C.L., and G.H. Muir. "Chronic urinary retention in men: how we define it, and how does it affect treatment outcome." BJU Int 110.11 Dec. 2012: 1590-1594.

Selius, B.A., et al. "Urinary retention in adults: diagnosis and initial management." American Family Physician 77.5 (2008): 643-650.

Yoon, P.D., V. Chalasani, and H.H. Woo. "Systematic review and meta-analysis on management of acute urinary retention." Prostate Cancer Prostatic Dis 18.4 Dec. 2015: 297-302.


Medically Reviewed by a Doctor on 11/9/2017
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