Aguirre Specialty Care
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Urinary Retention (Inability to Empty the Bladder)

Urinary retention is an inability to empty the bladder completely.  The two main types of urinary retention are acute urinary retention and chronic urinary retention.  Acute urinary retention is a sudden inability to empty the bladder.  This is associated with severe discomfort and is a medical emergency.  Chronic urinary retention is an inability to empty the bladder completely that develops over time. 

Symptoms

Symptoms of chronic urinary retention are a sense that the bladder does not empty completely, difficulty initiating urination, a slow, weak, or interrupted urinary stream, having to urinate multiple times to empty the bladder, dribbling of urine after completion of urination, urinary urgency or frequency, leakage of urine, and recurrent urinary tract infections.  Some women are unaware that they have urinary retention because they do not experience any symptoms.

Cause

The three main causes of urinary retention in women are a hypotonic bladder, dysfunctional voiding, and vaginal prolapse.  A hypotonic bladder muscle, also called a "lazy" or "neurogenic" bladder, does not contract (squeeze) hard enough during urination to empty the bladder completely.  Dysfunctional voiding is a condition in which the muscles around the urethra do not relax enough during urination to allow urine to pass freely.  Vaginal prolapse can kink or compress the urethra blocking the passage of urine.  Chronic urinary retention can be a result of one or more of these causes.

Diagnosis

Click here for information on diagnostic testing.

Treatment

NON-SURGICAL TREATMENT OPTIONS FOR URINARY RETENTION 

Pelvic Floor Therapy

Pelvic floor therapy for urinary retention consists of a series of visits to a physical therapist with specialized training in the treatment of pelvic floor and bladder problems.  The physical therapist uses techniques such as biofeedback, functional electrical stimulation, and bladder training to help the nerves and muscles involved in emptying the bladder to function more normally. Click here for more information on pelvic floor therapy.  

Vaginal Pessary 

A vaginal pessary is a removable diaphragm-like device worn in the vagina.  It can hold support a prolapsing anterior vaginal wall, pushing the bladder back into its normal postion so that it can be emptied more completely.  There are a variety of types and sizes of pessaries available.  A pessary fitting includes two or more office visits to find a type and size of pessary that will work for you.  Click here for more information on vaginal pessaries.  

Clean Intermittent Self-Catheterization

Clean intermittent self-catheterization is for women with bothersome urinary retention.  A woman inserts a small tube through her urethra into her bladder for a few seconds after she urinates to drain the remaining urine in her bladder.  Click here for more information on clean intermittent self-catheterization.

SURGICAL TREATMENT OPTIONS FOR URINARY RETENTION

InterStim™ Therapy 

InterStim™ Therapy is an FDA-approved treatment for urinary urgency, frequency, urge incontinence, and retention.  The InterStim™ is a small device that is implanted under the skin of one of the upper buttocks.  It works by gently stimulating the sacral nerves to help the bladder function more normally.  Click here for more information on InterStim™ Therapy.

 

 

    

 



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Oscar A. AguirreDr. Aguirre is the Director of Aguirre Specialty Care, The Center for Female Pelvic Medicine. Dr. Aguirre is also a member of the Laser Vaginal Rejuvenation Institute of America.
OSCAR A. AGUIRRE, MD, FACOG