Share Your Story There are a number of medical conditions and medications that may cause urinary retention. Obstruction may be fixed due to a mass blocking the bladder outlet or dynamic lack of coordination between the bladder and the muscles surrounding the bladder outlet and urethra. There are also infectious causes and surgical causes of urinary retention. The most common cause of blockage of the urethra in men is enlargement of the prostate.
In males, the prostate gland surrounds the urethra. The most common cause of prostate enlargement is benign prostatic hypertrophy often called BPH. Other causes of prostate enlargement include prostate cancer. Acute infection of the prostate prostatitis may cause swelling of the prostate and lead to urinary retention. Less common obstructive causes in men include meatal stenosis narrowing of the opening at the tip of the penis that urine passes through, which may be the result of chronic irritation or prior hypospadias surgery , paraphimosis in which the foreskin in an uncircumcised male retracts and cannot be pulled back down, resulting in swelling and constriction , penile constricting bands, and penile cancer.
Other causes of blockage of the urethra that can occur in both males and females include scar tissue in the urethra from prior trauma , surgery or infection urethral stricture , injury to the bladder outlet or urethra as in a car accident or bad fall , blood clots due to bladder infection or trauma, tumors in the bladder or pelvic region, severe constipation , and bladder or urethral stones or foreign bodies in the bladder or urethra.
Bladder-sphincter dysfunction may be voluntary or involuntary. Chronic tightening of these muscles leads to an inability to properly relax the muscles when urinating. Lastly, in women, obstruction to the outflow of urine may be due to a large cystocele, or herniation of the bladder into the vagina, or may be the result of surgeries to treat urinary incontinence, such as sling procedures.
Disruption of the nerves between the bladder and the brain can cause you to lose control of your bladder function. The problem may lie in the nerves that send messages back and forth or in the nerves that control the muscles used in urination, or both.
Individuals who suffer from such conditions are referred to as having a "neurogenic bladder. The most common causes of this disruption include spinal cord injury, spinal cord tumor , strokes, diabetes mellitus , herniated or ruptured disk in the vertebral column of the back, or an infection or blood clot that places pressure on your spinal cord, and congenital spinal cord problems such as myelomeningocele spina bifida and tethered spinal cord.
Nerve problems can also affect the ability of the muscles around the urethra to relax during urination, known as detrusor sphincter dyssynergia DSD , which can lead to urinary retention. In males, inflammation of the head of the penis, the glans balanitis , and infection of the prostate prostatitis or an abscess of the prostate may result in urinary retention. In women, infection of the vulva and vagina, vulvovaginitis, as well as chronic inflammation and resultant scarring, lichen sclerosus, may cause urinary retention.
Herpes simplex virus can cause pain in the perineum and affect the nerves leading to urinary retention. Infections around the spinal cord can cause retention by placing pressure on the nerves of the spinal cord. Trauma to the pelvis, penis, and perineum can cause urinary retention. Fractures of the pelvis can cause damage to the bladder outlet and urethra, and the healing of such injuries can lead to obstruction from scar tissue.
Urinary retention is a relatively common problem after surgery. It can be a direct result of the anesthetic or the type of operation. Relative immobility after a surgery can also contribute to urinary retention. Previous bladder or prostate surgeries can sometimes cause urinary retention because of the formation of strictures narrowing due to scar tissue.
This can occur after prostate cancer surgery radical prostatectomy as well as surgery for benign prostate enlargement BPH transurethral prostatectomy, laser prostatectomy, and cryotherapy. Chronic overdistention of the bladder holding one's urine for long periods of time or excess alcohol intake can lead to urinary retention. Immobility may result in urinary retention.
Other causes of transient urinary retention include immobility especially post-operative , constipation , delirium, endocrine hormone problems, psychological problems, and prior instrumentation medical procedures involving placing instruments in the urethra of the urethra. Medication-Related Causes Certain medications can cause urinary retention, especially in men with prostate enlargement.
Many of these medications are found in over-the-counter cold and allergy preparations. These drugs include the following: Drugs that act to tighten the urinary channel and block the flow of urine include ephedrine Kondon's Nasal, Pretz-D , pseudoephedrine Actifed, Afrin , Drixoral , Sudafed , Triaminic , phenylpropanolamine Acutrim, Dexatrim, Phenoxine, Prolamine , phenyleprhine neosynephrine , and amphetamines.
Antihistamines such as diphenhydramine Benadryl, Compoz, Nytol, Sominex and chlorpheniramine Chlor-Trimeton , Allergy 8 Hr , as well as some older antidepressants , can relax the bladder too much and cause urination problems.
Cox-2 inhibitors, used for treating such conditions as sports injuries, arthritis , colorectal polyps, and menstrual cramps Some medications used to treat heart arrhythmias may affect urination, including disopyramide Norpace , procainamide Pronestyl , and quinidine.