[1] When of gradual onset, symptoms may include loss of bladder control, mild lower abdominal pain, and a weak urine stream.
[1] Blockage can be caused by benign prostatic hyperplasia (BPH), urethral strictures, bladder stones, a cystocele, constipation, or tumors.
[1] Medications that can cause problems include anticholinergics, antihistamines, tricyclic antidepressants, cyclobenzaprine, diazepam, nonsteroidal anti-inflammatory drugs (NSAID), Stimulants, and opioids.
[1] When of gradual onset, symptoms may include loss of bladder control, mild lower abdominal pain, and a weak urine stream.
[citation needed] In the longer term, obstruction of the urinary tract may cause:[citation needed] Risk factors include Chronic urinary retention that is due to bladder blockage which can either be as a result of muscle damage or neurological damage.
[7] If the retention is due to neurological damage, there is a disconnect between the brain to muscle communication, which can make it impossible to completely empty the bladder.
[citation needed] In adults older than 60 years, 50-100 ml of residual urine may remain after each voiding because of the decreased contractility of the detrusor muscle.
[citation needed] Non-neurogenic chronic urinary retention does not have a standardized definition; however, urine volumes >300mL can be used as an informal indicator.
[citation needed] In acute cases of urinary retention where associated symptoms in the lumbar spine are present such as pain, numbness (saddle anesthesia), parasthesias, decreased anal sphincter tone, or altered deep tendon reflexes, an MRI of the lumbar spine should be considered to further assess cauda equina syndrome.
BPH may respond to alpha blocker and 5-alpha-reductase inhibitor therapy, or surgically with prostatectomy or transurethral resection of the prostate (TURP).
Urinary retention, including drug-induced cases, may be an early sign of benign prostatic hyperplasia (BPH).
Treatment typically includes α1-receptor antagonists such as tamsulosin, which relaxes smooth muscle in the bladder neck, and 5α-reductase inhibitors like finasteride and dutasteride, which reduce prostate enlargement.
Clinical trials have demonstrated that combining these medications improves urinary symptoms and lowers the likelihood of retention recurrence.
[12] Baclofen, a gamma-aminobutyric acid (GABA) agonist, acts on GABAergic interneurons in the sacral intermediolateral cell column, facilitating the relaxation of the striated urinary sphincter during voiding.
[13] Electrical stimulation, or neuromodulation involves the application of electrodes to induce controlled contraction and relaxation of the pelvic floor muscles.
The goal of this intervention is to facilitate relaxation of the external sphincter and pelvic floor muscles, which may assist in voiding.
Patients can be taught to use a self catheterization technique in one simple demonstration,[19] and that reduces the rate of infection from long-term Foley catheters.
Self catheterization requires doing the procedure periodically during the day, the frequency depending on fluid intake and bladder capacity.
[22] A meta-analysis on the influence of voiding position on urodynamics in males with lower urinary tract symptoms showed that in the sitting position, the residual urine in the bladder was significantly reduced, the maximum urinary flow was increased, and the voiding time was decreased.
Cancers often present with blood in the urine, weight loss, lower back pain or gradual distension in the flanks.