One thing most of us take for granted is being able to urinate without problems. Males, for whom the world is our toilet, have to be sure a much easier time than females of relieving ourselves at a moment’s notice. Ironically, males also suffer much more frequently from acute urinary retention. This is a condition in which the bladder is full, but you are unable to lessen the load-the plumbing doesn’t work.
What we will be discussing are obstructive causes of urinary retention. You should know that there are other causes which are not due to obstruction. These include neurologic conditions such as acute paralysis, medications which impair the nerves controlling urination and brain diseases such as stroke. And there are many other causes as well.
By far the most common cause in men is prostate enlargement from infection, inflammation or as a consequence of age. For females,the causes are different, as obviously women don’t have prostates. Cancer, scar tissue or benign tumors can block urine outflow as can a kinked urethra (the pipe from your bladder to the outside) from a uterus which has dropped a little from age. A stone within the urethra can also block the urine from going where it should-outside your body.
Acute urinary retention causes the bladder to become full and this is very painful. Within a few hours the discomfort becomes unbearable. At times a few drops of urine can be produced, but of course this is not nearly enough to do the job.
What is needed is a catheter, which is carefully and gently inserted into the urethra. This allows for the rapid exit of urine-sometimes over a quart comes out rapidly. This procedure can be easily performed by nurses as well as doctors and usually only requires a local anesthetic gel. If the prostate is very large, a special, more rigid and bent catheter might have to be placed by the doctor. If this is not successful, then a suprapubic catheter will be placed. This is a minor surgical procedure, in which the doctor bypasses the obstructed urethra by placing the catheter just below the belly button, directly into the bladder.
Sometimes the catheters are pulled out after the obstruction is relieved, but at other times the catheter may be left in place. This would be done in order to avoid a recurrence of the obstruction.
While placing the catheter is not the most pleasant of experiences, neither is feeling like your bladder might burst. By the way, the bladder can burst and if it does this will cause a serious peritonitis. So if you can’t urinate and feel the urge, you should go to the emergency room sooner than later.