What is Chronic Urinary Retention?
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Chronic Urinary Retention: Causes, Symptoms, Diagnosis, Complications & Treatment

Published on Dec 15, 2022   -  5 min read


Chronic urinary retention is the inability to empty urine completely. To know more, read the article.


The bladder acts as a storage tank for the waste product of urine. When the bladder is full, the person will urinate, and the waste will leave the body. However, if the person has urinary retention, the bladder will not empty the urine completely, resulting in retention. This can happen to both men and women, and it can be caused by many things like medications, blockages, and nerve issues. Chronic urinary retention generally develops slowly over months to years and is not painful, which is asymptomatic or may be associated with lower urinary tract symptoms such as urinary frequency, incontinence, or urgency.

What Is Urinary Retention?

Urinary retention is a condition where the individual is unable to empty all the urine from the bladder. It is a condition that is related to other health problems, such as prostate problems in men and a cystocele (bladder bulges into the vagina) in women. Urinary retention can be acute (a sudden inability to urinate) and chronic (a gradual inability to empty the bladder).

What Is Chronic Urinary Retention?

Chronic urinary retention, as the name indicates, develops over a longer period. The individual with chronic urinary retention can urinate but cannot empty the bladder completely. Many people with chronic urinary retention do recognize the condition since they may not experience any symptoms.

What Are the Causes of Chronic Urinary Retention?

  • Aging causes changes in the urinary tract resulting in the inability to empty the bladder.

  • Urethral blockage can cause urinary retention. This includes a full bladder, constipation, an enlarged prostate gland (in males), urinary tract stones, vaginal prolapse (in females), tumors, and narrowing of the urethra.

  • Nerve damage may cause urinary retention. This includes spinal injuries and health conditions affecting the nervous system- diabetes, multiple sclerosis, stroke, and Parkinson's disease.

Other causes of chronic urinary retention include:

  • Recent surgery pain.

  • Medications.

  • A urinary tract infection

  • Recent delivery.

What Are the Symptoms of Chronic Urinary Retention?

Urinary retention usually takes longer to notice the symptoms. The symptoms include:

  • Strain while passing urine.

  • Weaker urine flows with a slow start.

  • Feeling full bladder even after passing the urine.

  • Overflow incontinence (leakage of urine without control).

  • Difficulty in controlling urine during cough and sneeze.

  • Frequent urination at night.

  • Abdominal swelling.

  • Pain in the abdomen.

How to Diagnose Chronic Urinary Retention?

  • Urinalysis.

  • Urine culture.

  • Renal function test.

  • Prostate-specific antigen test.

  • Urodynamic testing.

  • Renal, bladder, and transrectal prostate ultrasound.

  • Brain and pelvic computed tomography (CT).

  • Brain and lumbosacral spine magnetic resonance imaging.

  • Cystoscopy.

  • Retrograde cystourethrography.

How Common Is Urinary Retention?

Urinary retention is common in men and increases as they grow older. Over a period of five-year, approximately one in 10 men of 70 years and almost one in three men of 80 years will develop urinary retention. Whereas urinary retention is less common in women and rare in children. Every year, about three in 100,000 women develop urinary retention.

Who Is More Likely to Develop Urinary Retention?

Urinary retention is common in both men and women, but men of older age groups are commonly affected. Men having benign prostatic hyperplasia (the prostate gland is enlarged) are more likely to develop urinary retention. In this condition, the prostate enlarges and pushes against the urethra resulting in blockage of urine out of the bladder.

What Are the Complications of Urinary Retention?

  1. Urinary Tract Infection: When the urinary tract is emptying completely, bacteria that normally enter the urinary tract are flushed out during urination. With urinary retention, the urine does not completely drain out, which allows the harmless bacteria a chance to multiply and infect the urinary tract. Serious problems can occur if the infection spreads to the kidneys.

  2. Bladder Damage: If urinary retention is not treated, the bladder may become stretched too far. When stretched too far, the muscles in the bladder may become damaged and no longer perform their normal function.

  3. Kidney Damage: The urinary tract is designed to have the urine flow from the kidneys, through the ureters, to the bladder, and out the urethra. If the individual has urinary retention, it becomes difficult for them to empty the urine from the bladder, and the urine may back up into the kidneys. This makes the kidneys full of urine so that they swell and ultimately press the nearby organs. This pressure can damage the kidneys and, in some cases, may lead to kidney failure and chronic kidney disease.

  4. Urinary Incontinence: When the bladder does not empty fully, it leads to urine leakage, called urine overflow incontinence.

What Is the Treatment for Chronic Urinary Retention?

Based on the etiology, the treatment plan is suggested by the physician. Therefore, it is important to perform tests to identify the etiology. Many treatments are available for chronic urinary retention:

  • Catheterization: Occasional or long-term catheterization is required for chronic urinary retention. The physician will teach the individual how to self-catheterize in case of necessity.

  • Urethral Dilation: Urethral strictures are treated using urethral dilation.

  • Urethral Stents: Here, an artificial tube called a stent is inserted into the urethra to relieve the stricture. Once placed, the stents expand like a spring and push the surrounding tissues, thereby widening the urethra.

  • Surgery: Surgical interventions include prostate surgeries for men and pelvic organ prolapse repair for females will be required.

  • Pharmacological Interventions: The following medications can reduce urinary retention but should be taken under the physician's advice.

  1. Alpha Blockers: Doxazosin, Prazosin, Tamsulosin, Terazosin, Alfuzosin, and Silodosin.

  2. 5-Alpha Reductase Inhibitors: Dutasteride and Finasteride.

  3. Combination Therapy: Tamsulosin and Dutasteride.

When Should the Individual See a Doctor?

The individual should consult the physician in case of:

  • Unable to pass urine.

  • Pain and burning sensation, along with an inability to pass urine.

  • Blood in the urine.

  • Once the symptoms do not regress with treatment.

  • Feeling unwell.

  • Fever.

  • Abdominal pain.

  • Urine has a bad smell.

  • No urination for four hours.


Working with a healthcare professional to prevent and treat these complications is important for both the health of the urinary tract and overall wellness. In men, it is important to determine whether the retention is due to high-pressure or low-pressure retention, as this sometimes affects the treatment decisions.

Frequently Asked Questions


How Do You Treat Chronic Urinary Retention?

The treatment of chronic urinary retention can depend upon its cause. Catheterization, urethral dilatation, urethral stents, surgery, or medications can be used to treat urinary retention. Medications can include alpha-blockers, 5 alpha-reductase inhibitors, or a combination of these can be used.


Can Urinary Retention Be Treated?

Yes, chronic urinary retention can be treated. The duration of the treatment will depend on the severity of the causative condition. At times consulting some specialists like a urologist, proctologist, or pelvic floor specialist might be required.


Is Urinary Retention Harmful?

Yes, Urinary retention can be harmful and be a cause of pain if left untreated. Diagnosing the underlying cause and prompt treatment is essential to prevent complications. Sometimes it can cause the urine to flow back to the kidneys, causing scarring and damage to the kidney parenchyma. This can lead to kidney damage if left untreated.


Can Urinary Retention Be Cured Naturally?

Physical therapy is the best way to cure urinary retention. Keegel’s exercise is the best to strengthen the muscles of the pelvic floor. This helps to improve pelvic floor functions and helps to prevent urinary retention.


How Is Urinary Retention Diagnosed?

Urodynamic testing is done to diagnose urinary retention. Urometry tests help to know about the flow of urine and to know how much urine is released each time. Pressure flow rate helps to give details on the rate of urine flow and the flow of urine and the pressure in the bladder.


What Is Surgery for Urinary Retention?

Transurethral resection of the prostate is the common surgical approach for urinary retention. A section of the prostate is removed using a small tool by the urologist in this procedure. Several tests are done before the surgery. Other surgical procedures can include the removal of urethral strictures, correcting organ prolapse, and urinary diversion.


How Much Urinary Retention Is Normal?

If 100ml or more urine is left behind after voiding, it can be indicative that the bladder is not emptied completely. The normal capacity of the bladder is 500ml. If more than 500ml is retained, it is suggestive of urinary retention.


Can Drinking More Water Cure Urinary Retention?

Drinking more water can help to manage the condition, though it cannot be a cure. Staying hydrated prevents the kidneys from making the urine more concentrated. Hence, irritations due to concentrated urine can be avoided.


Can Urologists Treat Urine Retention?

Urologists can treat urinary retention. Many diagnostic tests are performed to know the exact cause. CT scans and cystoscopy are the most commonly suggested diagnostic tests. CT scan provides details on tumors, stones, and other causes for urine retention. Cystoscopy provides details of any strictures or any other defects in the bladder.


Who Is Most at Risk for Urinary Retention?

Men with benign prostatic hyperplasia are at a higher risk for urinary retention. Benign Prostatic Hyperplasia is a condition in which the prostate is enlarged abnormally. Men are at a higher risk than women for the condition.  Young sexually active men and men over 50 years are at higher risk.

Last reviewed at:
15 Dec 2022  -  5 min read




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