Urinary retention 1099226 221389551 2008-06-24T08:53:53Z Thijs!bot 1392310 robot Adding: [[it:Ritenzione urinaria]] {{SignSymptom infobox | Name = Urinary retention | ICD10 = {{ICD10|R|33||r|30}} | ICD9 = {{ICD9|788.5}} | }} {{Unreferenced|date=June 2008}} '''Urinary retention''' also known as '''ischuria''' is a lack of ability to [[urinate]]. It is a common complication of [[Benign prostatic hyperplasia|benign prostatic hypertrophy]] (also known as benign prostatic hyperplasia or BPH), although [[anticholinergic]]s may also play a role, and requires a [[catheter]]. Various medications (e.g. some [[antidepressant]]s) and recreational use of [[amphetamine]]s and opiates are notorious for this. == Signs and symptoms == Urinary retention is characterised by poor urinary stream with intermittance, straining, a sense of incomplete voiding and urgency. As the bladder remains full, it may lead to [[urinary incontinence|incontinence]], [[nocturia]] (need to urinate at night) and high frequency. Retention is a '''medical emergency''', as the bladder may distend (stretch) to enormous sizes and possibly tear if not dealt with quickly. If the bladder distends enough it will begin to become painful. The water can also pass back up the ureters and get into the kidneys, causing kidney failure. A person should go straight to an emergency department as soon as possible if unable to urinate when having a painfully full bladder. In the longer term, obstruction of the urinary tract may cause: * [[Bladder stone]]s * Loss of detrusor muscle tone (atonic bladder is an extreme form) * [[Hydronephrosis]] (congestion of the kidneys) * Hypertrophy of detrusor muscle * Diverticula in the bladder wall (leads to stones and infection) == Causes== * [[Benign prostatic hypertrophy]] * [[Prostate cancer]] and other pelvic [[cancer|malignancies]] * Congenital urtheral valve abnormalities * Detrusor muscle [[dyssynergia]] * [[Circumcision]] * Damage to the bladder * Obstruction in the urethra, for example a metastasis or a precipitated pseudogout crystal in the urine * [[Paruresis]] ("shy bladder syndrome")- in extreme cases, urinary retention can result * Consumption of some [[Psychoactive drug|psychoactive substances]], mainly [[stimulant]]s, such as [[Methylenedioxymethamphetamine|Ecstasy]]. == Diagnostic tests == [[Uroflowmetry]] may aid in establishing the type of micturition abnormality. A post-void residual scan may show the amount of urine retained. Determination of the serum [[prostate-specific antigen]] (PSA) may aid in diagnosing or ruling out prostate cancer. [[Urea]] and [[creatinine]] determinations may be necessary to rule out backflow kidney damage. == Treatment == In ''acute'' urinary retention, [[urinary catheterization]] or [[suprapubic cystostomy]] instantly relieves the retention. In the longer term, treatment depends on the cause. Benign prostatic hypertrophy may respond to [[alpha blocker]] and [[5-alpha-reductase inhibitor]] therapy, or surgically with [[prostatectomy]] or [[transurethral resection of the prostate]] (TURP). == See also == * [[Constipation]], inability to defecate * [[Urinary incontinence]], inability to ''hold'' the urine == References == <references/> {{Symptoms and signs}} [[Category:Symptoms]] [[Category:Urology]] [[ar:انحصار البول]] [[de:Harnverhaltung]] [[fr:Rétention aigüe d'urine]] [[it:Ritenzione urinaria]] [[pt:Retenção urinária]] [[zh:尿瀦留]]