Urine Retention

Urinary retention means you cannot empty your bladder all the way, or at all. It can happen in people with cancer. Causes can include blockages, narrowing of the urethra (strictures), damage to pelvic floor muscles, medicines, and other health problems.

What is urinary retention?

Urinary (or bladder) retention is when you cannot empty your bladder, which stores urine until you are ready to pee. Some people cannot empty their bladder at all, while others cannot empty it fully.

Urinary retention can lead to problems such as:

• Urinary incontinence
• Urinary tract infections (UTIs)
• Sepsis
• Bladder or kidney damage

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. It is usually a medical emergency that requires urgent treatment.

Certain things increase your risk of acute urinary retention, including:

• 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

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

What causes urinary retention?

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

• Constipation
• Medicines such as opioids, antidepressants, and muscle relaxants
• Surgery and anesthesia
• Enlarged prostate (BPH)

Cancer-related causes of urinary retention might 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
• Pelvic prolapse, which happens when the bladder, uterus, or rectum slips into the vaginal canal because of weak pelvic wall muscles

Tests for urinary retention

If you have signs of urinary retention, your cancer care team might order tests, such as:

• 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 kidney function
• 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 can vary. They sometimes seem like symptoms of a urinary tract infection (UTI).

The most common symptoms are:

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

Tips to manage urinary retention

• Empty your bladder at least every 4 hours, even if you do not feel like you need to.
• Prevent and manage constipation.
• Ask your cancer care team or doctor if any of your medicines could be causing retention or making it worse.

Do not:

• Try to hold it if you feel like you need to pee.
• Push or strain when trying to pee.
• Use products that can irritate your bladder, such as scented wipes, soaps, or sprays.

When to talk to your doctor or cancer care team

Tell your care team if you:

• Suddenly cannot 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 symptoms you should call about right away. Ask which symptoms you can wait until office hours to call about. Make sure you know who to contact when the office is closed or after business hours.