When no urine comes out, the condition is most likely urinary retention, which signifies the bladder isn't emptying completely.
Understanding Urinary Retention
Urinary retention can be acute (sudden) or chronic (long-term). It signifies a problem preventing the complete emptying of the bladder. This issue can stem from several underlying causes.
Causes of Urinary Retention
- Blockage: An obstruction in the urethra, the tube that carries urine from the bladder, can prevent urine flow. Examples include:
- Enlarged prostate (BPH): Common in older men, this can compress the urethra.
- Urethral strictures: Narrowing of the urethra due to scar tissue.
- Kidney stones: Stones lodged in the urethra can cause a blockage.
- Tumors: Growths in the bladder or urethra.
- Nerve Problems: The bladder muscles and sphincters (muscles that control urine flow) require nerve signals to function correctly. Problems with these nerves can lead to urinary retention. Common causes include:
- Spinal cord injury: Damage to the spinal cord can disrupt nerve signals.
- Stroke: Can affect the brain's ability to control bladder function.
- Diabetes: Can damage nerves over time (diabetic neuropathy).
- Multiple sclerosis (MS): An autoimmune disease that affects the brain and spinal cord.
- Medications: Certain medications can interfere with bladder function and contribute to urinary retention. Examples include:
- Anticholinergics: Used to treat overactive bladder.
- Antihistamines: Used to treat allergies.
- Tricyclic antidepressants: Used to treat depression.
- Opioid pain relievers: Can decrease bladder muscle contractions.
- Other Factors:
- Surgery: Anesthesia and certain surgical procedures can temporarily affect bladder function.
- Infection: Severe urinary tract infections (UTIs) can sometimes lead to retention.
Symptoms of Urinary Retention
Symptoms vary depending on whether the retention is acute or chronic:
- Acute Urinary Retention:
- Sudden inability to urinate.
- Severe pain in the lower abdomen.
- Urgent need to urinate but inability to do so.
- Chronic Urinary Retention:
- Frequent urination (more than 8 times a day).
- Difficulty starting urination.
- Weak urine stream.
- Feeling like the bladder isn't completely empty after urinating.
- Frequent small amounts of urine leakage (overflow incontinence).
Diagnosis and Treatment
A healthcare professional can diagnose urinary retention through:
- Physical Exam: Includes assessing the abdomen and potentially a rectal exam (in men).
- Post-Void Residual (PVR) Measurement: Measures the amount of urine remaining in the bladder after urination.
- Urine Tests: To check for infection or other abnormalities.
- Imaging Tests: Such as ultrasound or CT scan, to visualize the bladder and urinary tract.
Treatment depends on the underlying cause:
- Catheterization: Inserting a catheter into the bladder to drain urine. This provides immediate relief and can be either intermittent (done as needed) or indwelling (left in place).
- Medications: To treat an enlarged prostate (e.g., alpha-blockers, 5-alpha reductase inhibitors) or other underlying conditions.
- Surgery: To remove blockages such as prostate enlargement, urethral strictures, or tumors.
- Nerve Stimulation: In some cases, nerve stimulation techniques can help improve bladder function.
Urinary retention requires medical attention to prevent potential complications, such as bladder damage, kidney damage, and urinary tract infections.
