Urinary Retention – causes – diagnosis – treatment
Dr.Kut | May 28, 2010 | Comments 0
Urinary retention (commonly called Ischuria urine retention) is the condition in which in a person is unable to urinate. It relates to complexities in the benign prostatic hypertrophy. Several medications can lead to the retention of urine, like the COX-2 inhibitors, opiates, antidepressants and amphetamines.
Urine retention signs and symptoms are many. Some of them include, straining, hesitancy, sense of unfinished voiding and intermittent flow. Due to the fact that in the condition of male urine retention as well as female urine retention, the bladder remain full at all times, one may incur incontinence nocturia (the urge to urinate during the night) at a very high frequency. In such cases, the bladder stretches itself to unusual sizes and may even tear off at its worst. Urine retention is an extremely painful condition. Due to the inability to pass out, the urine may even be pushed back into the kidneys leading to hydronephrosis or even pyonephrosis. Due to the serious post effects of urine retention, once must immediately seek for medical help.
Looking into the details of how one incurs the condition, there numerable urine retention causes. The reasons of it occurring in the bladder are neurogenic bladder, detrusor spinchter dyssynergia, any damage caused to the bladder and latrogenic scarring in the neck of the bladder. The causes of urine retention occurring in the prostrate are Prostatitis, pelvic malignancies, prostate cancer and benign prostatic hyperplasia. In addition, when urine retention takes place in the penile urethra, the most obvious causes can be urethral obstruction, pinhole meatus, congenital urethral valves, STD lesions and circumcision. Besides, urine retention can also occur due to Paruresis, consumption of certain psychoactive stuff, usage of drugs or NSAIDs that have anticholinergic characteristics, and metastases or stones.
The urine retention diagnosis includes certain urine flow tests that detect exact micturition abnormality. It gives you the details like the intermittent flow, post void residuals if any and the rate of flow. The normal flow rate is about 20 – 25 ml per second. The post void residual being more than 50 ml indicates the possibility of reoccurrence of urine infections. In adults, the residual urine is almost double of normal because of the reduced contractility of detrusor muscle. In the more severe cases of urine retention, an ultrasound of the bladder may be included in the diagnosis in order to rule out or recognize specific conditions. Some of the other tests that may be conducted are, determining the prostate specific antigen, TRUS biopsy, creatine and serumurea determination, cystoscopy and MRI of lumbar spine.
The most commonly carried out urine retention treatment is the placement of a suprapubic cystostomy or prostatic stent. These relieve the retention instantly. The other optional treatments entirely depend on the causes of the issue. the surgical procedure that is carried out in chronic cases of urine retention is transurethral resection of the prostate or prostatectomy. Once these are done, the post-operative urine retention period is quite relieving and not even all that stressful.
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