The inability to empty one’s own bladder is also referred to in medicine as so-called urinary retention or urinary obstruction. Depending on the respective symptoms, a distinction is made between acute urinary retention and chronic urinary retention.
What is urinary stasis?
If there is an obstruction in the urinary tract, the affected person’s urine can no longer flow freely. The obstructions usually appear in the area of the kidneys or in the area of the ureters. Depending on the degree of severity, however, an obstruction can also occur in the area of the bladder or in the area of the faucet tube.
If left untreated, urinary retention can be life-threatening for those affected. For example, if bacteria enter the bloodstream from the urogenital tract, this can lead to life-threatening blood poisoning.
Depending on the degree of severity, chronic kidney failure can occur in addition to what is known as urosepsis. The affected person must always undergo dialysis as part of chronic kidney failure. In order to determine an optimal therapy, however, the causes of urinary retention must first be determined.
According to Abbreviationfinder.org, the causes of urinary stasis include stones in the ureters and kidneys. Not infrequently, however, tumors also promote the occurrence of urinary obstruction.
If the body is exposed to a high level of violence, for example as part of an accident, a so-called trauma can lead to acute urinary retention.
Often those affected can no longer actively control their urine flow due to an underlying neurological disease. For example, in the case of paraplegia, it is necessary to insert a urinary catheter. Chronic urinary retention is primarily promoted by congenital narrowing of the urethra.
Symptoms, Ailments & Signs
Urinary retention can be sudden or gradual. It is associated with severe pain and pressure in the lower abdomen. The bulging bladder can no longer empty itself and overflows. Therefore, in addition to the pain, the patient complains of constant dribbling of urine. This dribbling of urine cannot be suppressed and is therefore referred to as overflow incontinence.
The flank pain is unbearable in acute urinary stasis. It is colicky pain that sometimes radiates to the groin or genitals. Sometimes there is blood in the urine. In some cases, chills and fever may occur. This is a particularly life-threatening emergency because it could be a so-called urosepsis.
Complete urinary retention, in which even overflow incontinence is absent, is rarely observed. The urine then accumulates in the renal pelvis and the ureters and leads to long-term kidney damage. However, acute urinary stasis can heal without consequential damage if treatment is initiated in good time. Chronic urinary retention leads to consequential damage, which is particularly noticeable in renal insufficiency or even kidney failure.
The chronic urinary stasis can remain completely symptom-free. In some cases, however, flank pain, nausea and vomiting also occur here. If kidney damage is already present, blood is also observed in the urine. Other symptoms are caused by the underlying disease.
Diagnosis & History
So-called sonography is used as an imaging method to diagnose urinary obstruction. By using ultrasound, the doctor can see any obvious changes in the tissue around the urethra.
Computed tomography is often ordered to confirm the first finding. By administering a so-called contrast medium, the underlying tissue can be examined more closely. However, computed tomography ( CT ) is only used if there is a suspicion of a pathological change in the surrounding tissue.
As an alternative to conventional computed tomography, leading physicians use so-called excretory urography to diagnose urinary obstruction. A special contrast medium is administered to the affected person via the arm vein. The contrast medium is usually enriched with iodine for better visualization.
Depending on the severity, those affected complain of slight pain in the kidney area. Over time, there is an increased loss of functioning kidney tissue. Thus, in most cases, urinary retention leads to an increased susceptibility to infections.
Urinary retention can lead to various complications. A build-up of urine in the urinary bladder leads to a painful overstretching of the bladder. It can also easily infect the urinary bladder. Over time, the infection can spread throughout the body and lead to blood poisoning or sepsis.
This is life-threatening for the person affected and must be treated immediately, otherwise it can lead to septic shock. This leads to an insufficient supply of blood to organs, which can die as a result. The kidneys and lungs are particularly affected.
Furthermore, the urinary retention can lead to an infection of the kidneys, which can then fail over time (renal insufficiency). In this case, the kidneys are no longer able to adequately filter the urine, and the water remains in the body. As a result, the affected person has more blood volume, resulting in increased edema. High blood pressure is also the result, which can lead to further impairments.
In addition, the acid-base balance and the electrolyte balance are also disturbed. More acids accumulate in the body, which means that more potassium also accumulates in the blood, which promotes cardiac arrhythmias. In the worst cases, the affected person has to undergo lifelong dialysis or even a kidney transplant.
When should you go to the doctor?
Urinary retention and pain when urinating indicate urinary retention. A doctor should be consulted if symptoms persist for more than a day or two or other symptoms appear. Cramping pains indicate that the urine is already pressing on the urinary tract and should be clarified quickly. An acute feeling of illness indicates an infection. At the latest when fever symptoms appear, medical advice is required. Signs of renal colic or another serious secondary disease must also be clarified immediately by a doctor.
The affected person should have urinary retention diagnosed and treated before blood poisoning occurs. Sepsis can lead to septic shock, which requires intensive care treatment. If the person affected shows signs of such a shock, the first responders should alert the emergency doctor. In the best case, urinary retention is detected early and treated directly by the general practitioner. An early clarification allows a symptom-free and fast treatment. Other contacts are the urologist and specialists in internal medicine.
Treatment & Therapy
In the case of urinary obstruction, the choice of therapy depends primarily on the symptoms and the localization of the complaints. If the urinary stasis is accompanied by a bacterial infection, treatment with antibiotics is recommended. However, the administration of antibiotics can only alleviate the acute symptoms.
Despite the administration of antibiotics, the underlying disease should always be treated. For example, a catheter is placed in the affected person as part of the therapy for urinary obstruction. This is the only way for the urine to drain continuously from the bladder. Placing a catheter can often prevent the further formation of bacteria.
The so-called nephrostomy is also becoming increasingly popular as a therapy for urinary obstruction. With this new form of therapy, the accumulated urine is drained through the skin. For this purpose, a so-called nephrostomy catheter is placed through the skin of the affected person under local anesthesia.
Outlook & Forecast
With early and comprehensive medical care, the prognosis for urinary obstruction is good. Urinary retention can be treated with medication. There is usually an improvement within a few days or weeks and the urine can be passed completely as usual.
Nevertheless, the clarification of the underlying cause is essential so that a permanent freedom from symptoms can occur. Otherwise, urinary retention will occur again after a short time. If infections or inflammations are present, they are usually treated together with the urinary obstruction. The patient can often be discharged from treatment after a short time as recovered.
If no therapy is initiated, germs and pathogens will develop and multiply. These trigger secondary diseases that can take an unfavorable course.
For a favorable prognosis, the cause of the disorder must be identified and treated. In some patients, a catheter is placed temporarily or permanently to ensure the drainage of urine. Pregnant women are at risk. They endanger the health of the unborn child if they see a doctor late or refuse treatment for the urinary obstruction. The growth of the child can be the cause of the symptoms and must be clarified by a doctor so that relief occurs.
To avoid urinary retention, it is advisable to have regular examinations for kidney stones. Appropriate therapy can be initiated as soon as the first signs of kidney stones appear. It is also advisable to go to the toilet regularly. This is the only way to thoroughly flush out dangerous bacteria. However, a doctor should always be consulted at the first sign of urinary obstruction.
In the case of urinary retention, there are few follow-up measures available to the patient. First and foremost, the underlying disease must be identified and treated so that this unpleasant complaint does not occur again and further complications can be prevented. The earlier the urinary blockage is recognized and treated, the better the further course of this disease is in most cases.
Since the focus is on early detection of the disease, the patient should consult a doctor as soon as the first symptoms and signs of the disease appear. The treatment itself depends on the exact reason for the symptoms, but is usually accomplished by taking medication. The person concerned should take care to take the prescribed dosage correctly and also follow the doctor’s instructions.
If you have any questions or anything is unclear, always consult a doctor first. Since urinary blockage is usually treated by taking antibiotics, the affected person should not drink alcohol. During treatment, many patients depend on the help and support of their own families. Intensive discussions can also prevent psychological upsets or depression.
You can do that yourself
In the case of urinary retention, the choice of treatment depends primarily on the symptoms. If the urinary stasis is the result of a bacterial infection, a doctor must be consulted in any case. The doctor will prescribe appropriate antibiotics and recommend that the patient drink plenty of water or unsweetened herbal or fruit tea.
A hot water bottle on the lower abdomen helps with urinary retention as a result of a bladder infection. In addition, warm underwear should be worn and cold seats avoided. Baths and visits to the sauna can drain the liquid from the skin and intestines, which often leads to an improvement in the symptoms.
Naturopathy recommends preparing a brew from fresh couch grass and drinking it in small sips. The regular consumption of horseradish, corn tea and foods containing calcium has also proven effective.
However, in the case of urinary retention as a result of bladder stones or a serious illness, medical treatment is always necessary. It is sometimes possible to support the therapy with home remedies, but this should always be done in consultation with the responsible doctor. If the measures mentioned have no effect, you should always consult your family doctor or a urologist.