Unable To Urinate
Reasons Why You Are Unable To Urinate
If you are unable to urinate, it is referred to as urinary retention and could be the result of a few different reasons. The problem is typically due to benign prostatic hyperplasia but it can also be due to infection, nerve dysfunction or medications such as antidepressants, amphetamines, opiates and COX-2 inhibitors. Quite often, a prostatic stint or catheter is required for diagnosis or treatment.
Urinary retention most commonly occurs in elderly males. It is reported that by 70 years old, at least 10 percent of all males are unable to urinate for one reason or another. Worldwide, this condition is known to occur in males regardless of color, race and ethnic background. It is important to seek medical treatment and not ignore it because it could ultimately be due to cancer.
Signs And Symptoms
Being unable to urinate is depicted by an abnormal urinary stream that has straining, hesitancy and an intermittent flow. Since the bladder stays quite full, it can cause the individual to urinate more frequently and throughout the night.
If the acute retention results in a complete stop in urination, this is considered an extreme medical emergency because the bladder could stretch quite large and even tear. If this happens, the increase of pressure that is being placed on the bladder can cause the urine to flow back upward and get into the kidneys. Once urine reaches the kidneys, it can cause kidney failure, sepsis and even pyonephrosis.
A urinary tract obstruction could also cause bladder stones, congestion of the kidneys, hypertrophy and diverticulitis, which can lead to infection and stones.
There are a multitude of causes that could be resulting in one being unable to urinate, such as:
- Prostate Causes – Pelvic malignancies, prostatitis and benign prostatic hyperplasia.
- Bladder Causes – Parkinson's disease, pelvic splanchnic nerve damage, descending cortical fibers lesion, detrusor sphincter dyssynergia, iatrogenic scarring and damage to the bladder.
- Penile Urethra Causes – Circumcision, congenital urethral valves, phimosis, obstruction and STD lesions.
- Other – Shy bladder syndrome and amphetamine usage.
Complications Of Acute Urinary Retention
Being unable to urinate generally occurs quite quickly in most people while in others it can be a gradual process. The pain can be excruciating if the urine cannot be released. Individuals can develop chest pain, high blood pressure, anxiety and severe sweating. It is rather common to suffer a heart attack after acute urinary retention and kidney failure and bladder damage can also occur. The sooner medical attention is received, the less complications that are generally experienced.
Treatment And Complications
To treat someone who is unable to urinate, a small tube called a catheter needs to be placed into the bladder. For some people, self-catheterization is used while for others, a Foley catheter is emplaced. The Foley catheter has an inflatable bulb that helps the catheter to stay in place. Self-catheterization is usually recommended when possible to reduce the higher risk of infection that is associated with the Foley catheter. For acute urinary retention, a catheter is inserted by a medical professional. If it is placed too close to the prostate, irritation and bleeding can occur.
For someone with a chronic type of urinary retention, surgery may be necessary. It is usually performed with a small instrument that is inserted into the person's urethra so that the obstruction can be removed. The most common risks are allergy to the medication or low blood pressure because of spinal anesthesia.
Other surgery complications could include prostate bleeding, bladder infection, scar formation and being unable to have an erection. Most complications remedy themselves in under one year and some medications may be required for certain individuals to decrease prostate enlargement.