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Managing Cancer Care

Urine Retention

Urinary retention is a condition where you can’t empty your bladder (the organ stores urine until you’re ready to pee). Blockages, strictures (narrowing), damage to pelvic floor muscles, medicines, and other health problems can all cause urinary retention (also called bladder retention).

Types of urinary retention

Acute urinary retention comes on suddenly and usually goes away over time. This is the most common type of urinary retention in people with cancer. Certain things increase your risk of acute urinary retention (AUR):

  • Having a prostate, especially as you age
  • Having a history of bladder or pelvic floor muscle damage
  • Having certain health conditions that cause nerve damage (such as diabetes)

Acute urinary retention is often a medical emergency that needs to be treated as soon as possible.

Chronic urinary retention usually develops slowly over time due to chronic (long-term) conditions such as benign prostatic hyperplasia (BPH), diabetes, and kidney problems.

What causes urinary retention?

Many things can cause bladder retention. Some common causes for people with cancer include:

  • Tumors near the bladder from any type of cancer
  • Brain and spinal cord tumors
  • Radiation therapy to the belly, bowel, pelvis, or reproductive organs (radiation cystitis)
  • Hormone therapy
  • Surgery and anesthesia
  • Constipation
  • Enlarged prostate (benign prostatic hyperplasia or BPH)
  • Pelvic prolapse - the bladder, uterus, or rectum slips into the vaginal canal because of weak pelvic wall muscles
  • Medicines such as opioids, antidepressants, and muscle relaxants

Tests for urinary retention

Your cancer care team might order tests if you have signs of urinary retention. Some common tests are:

  • Bladder ultrasound to measure the amount of urine in your bladder
  • Urine tests to check for infection or other problems
  • Blood tests to check your kidneys
  • Cystoscopy to look inside your urethra (the tube that urine comes out of) and bladder
  • CT scan or MRI to take pictures of your belly

Symptoms of urinary retention

Symptoms of urinary retention are different depending on the person. They sometimes seem like symptoms of a urinary tract infection (UTI).

The most common symptoms are:

  • Lower belly swelling, pain, or discomfort
  • Leaking urine
  • Difficulty starting to pee
  • Feeling like you need to pee but can’t
  • Feeling like you still need to pee after going
  • Peeing often but in small amounts

Call 911 or go to the emergency room  if you

  • Have sudden, intense belly pain that won’t stop
  • Can’t pee for a day or more
  • Have large amounts of blood in your pee
  • Have new numbness or tingling in your lower body
  • Usually self-catheterize and now you can’t

 

Treatment for urinary retention

It’s important to treat urinary retention because it can lead to other problems or even cause long-term damage to the bladder muscles.

Bladder drainage

The bladder is drained by inserting a soft tube called a catheter into the urethra and bladder. Catheters can be intermittent, meaning the catheter is inserted and removed each time the bladder is drained; or indwelling, meaning the catheter is inserted and left in place for a period of time. Some people with chronic urine retention learn to insert their own catheter at home to drain their bladder.

Urethral stents

If retention is caused by something blocking the flow of urine from the bladder, a urethral stent might be placed. A stent is a small catheter or tube that is inserted into the bladder and left in place. This usually can be done as an outpatient procedure or during an office visit. The stent may be temporary or kept for a long time to help drain the bladder.

Medicines

If urinary retention is caused by an enlarged prostate, medicines might help relax or even shrink the prostate. If retention is caused by an infection, antibiotics might be used.

Bladder training

Bladder training creates a schedule of times to pee. You also learn to use mental relaxation techniques to help with urges to go in between scheduled times, and track your progress in a bladder diary. The scheduled in-between times are made longer as you progress.

Pelvic therapy and biofeedback

Pelvic floor (Kegel) exercises can help stretch tight pelvic muscles that support the bladder or other organs in the abdomen. Therapists or nurses trained in pelvic therapy can help you create a plan that is best for your situation.

Biofeedback uses sensors placed near the anus to show on a screen which pelvic muscles are being exercised. Biofeedback can help make pelvic therapy more effective.

Surgery

In some cases, surgery might be used to treat retention:

  • To remove a tumor or part of the prostate
  • To repair a pelvic prolapse
  • To remove scar tissue
  • To change the direction of urine flow

Tips for managing urinary retention

  • Empty your bladder at least every 4 hours, even if you don't feel like you need to.
  • Don’t try to hold it if you feel like you need to pee.
  • Don’t push or bear down when trying to pee.
  • Don’t use products that can irritate your bladder such as scented wipes, soaps, or sprays.
  • Prevent constipation.
  • Ask your cancer care team or doctor if any of your medicines could be causing retention or making it worse.

Talk to your doctor or cancer care team

If you:

  • Suddenly can’t pee
  • Have pain or burning when you pee or try to pee
  • Feel like you still need to pee after you go
  • Notice blood in your pee
  • Have belly pain or vomiting
  • Have a fever with no known cause
  • Have other signs of infection such as sweating, chills, or a fast heartbeat

Ask your doctor or cancer care team what you should call right away for versus what can wait until office hours. Make sure you know who to contact when the office is closed.

 

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as editors and translators with extensive experience in medical writing.

Barrisford GW and Steele GS. Acute urinary retention. UpToDate. UpToDate Inc; 2023. Updated November 2023. Accessed December 21, 2023. https://www.uptodate.com/contents/acute-urinary-retention

McVary KT. Clinical manifestations and diagnostic evaluation of benign prostatic hyperplasia. UpToDate. UpToDate Inc; 2023. Updated November 2023. Accessed December 21, 2023. https://www.uptodate.com/contents/clinical-manifestations-and-diagnostic-evaluation-of-benign-prostatic-hyperplasia

Mueller ER. Postoperative urinary retention in females. UpToDate. UpToDate Inc; 2023. Updated May 2023. Accessed December 21, 2023. https://www.uptodate.com/contents/postoperative-urinary-retention-in-females

National Institute of Diabetes and Digestive and Kidney Diseases. Urinary retention. National Institutes of Health. Accessed December 21, 2023. https://www.niddk.nih.gov/health-information/urologic-diseases/urinary-retention

Rickey LM. Chronic urinary retention in females. UpToDate. UpToDate Inc; 2023. Updated April 2022. Accessed December 21, 2023. https://www.uptodate.com/contents/chronic-urinary-retention-in-females

Last Revised: April 22, 2024

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