The bladder is an organ that's part of the urinary system. Urine is stored in the bladder until it is pushed out and emptied from the body. Sometimes the bladder does not empty all the way. This is called urinary (or urine) retention. Urine might be retained if there is an obstruction or stricture (narrowing) in or around the bladder, or when muscles in or around the bladder are weak. Certain types and locations of tumors, certain medications, being dehydrated, or having constipation can also cause urinary retention.
Symptoms of urine retention
Urine retention can be uncomfortable and symptoms might include:
- Pain and bloating in the lower abdominal (belly) area.
- A frequent, urgent need to urinate but then having trouble doing it.
It's important to be checked if you have symptoms because urine that stays in your bladder for longer than it's supposed to could grow bacteria (become infected).
If your cancer care team thinks you might have urinary retention, they will order tests. Some of these tests include bladder ultrasound, cystoscopy, CT scans, urodynamic tests (measure urine output in different ways), or electromyography (an outpatient procedure that uses electric sensors to measure muscle and nerve activity around the bladder).
Managing urine retention
There are different ways to manage urine retention. Common ways include surgery to repair or strengthen the bladder, using a bladder catheter to drain urine, dilating or widening the urethra (the duct that urine flows through when emptied) called having urethral dilation or stents, and giving certain medications.
Bladder drainage
Inserting a catheter in the bladder can help relieve bladder fullness and help prevent damage. Sometimes it's necessary for patients to learn how to manage bladder drainage by inserting a catheter on your own. If using a catheter is needed, depending on the cause of the retention, it might be for a short or extended period of time. It's important to follow instructions for inserting a catheter to help prevent infection. You'll also likely be taught to track how much fluid you're drinking and how to measure urine drainage (output).
Urethral dilation or stents
This might be done if there is an obstruction or stricture in the urethra where urine flows through to be emptied. Dilating means the urethra is widened, using a small catheter or tube. A stent is a small catheter or tube that is inserted and left in place. Dilating can be done on its own or when a stent is needed. This is typically done as an outpatient or during an office visit with local anesthesia. The stent may be temporary or permanent to help drain the bladder.
Medications
Certain drugs can be given to help relax the bladder muscles. In men, some medications also help relax prostate muscles to relieve urinary retention symptoms.
Surgery
If tumors are in or around the bladder, surgery may help reduce any obstruction to the urethra and decrease urinary retention symptoms. For certain problems in the urethra, a urethrotomy uses incisions or a laser to open the stricture.
In some women, the tissue that supports the bladder and vagina areas can weaken and stretch, causing what's called a prolapse. A prolapse can be called a cystocele (between a woman's bladder and vaginal wall) or rectocele (front wall of the rectum bulges against the posterior of the vagina) depending on the area affected. The prolapse can often be repaired which involves the area being surgically "lifted."
Some men who have a non-cancerous condition called benign prostatic hyperplasia might have surgery to remove excess tissue that is causing urinary blockage.
What the patient can do
Here are some things that may help make urine retention less of a problem:
- Empty your bladder at least every 4 hours, even if you don't feel the urge to do so.
- Empty your bowels regularly.
- Get regular physical activity.
- If tolerated, drink 6 to 8 (8-ounce) glasses of fluid daily, preferably water.
- Talk to your doctor about all medicines, vitamins, herbs, and supplements you’re taking.
- Avoid drinks with caffeine or alcohol and citrus juices, which can irritate the bladder.
- Avoid hygiene products (soaps, feminine sprays, bubble baths) and chlorinated pools and hot tubs that may irritate the bladder
- Avoid smoking.