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General Practice 2023

Retenção urinária: what é, symptoms and treatment

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Retenção urinária: what é, symptoms and treatment
Retenção urinária: what é, symptoms and treatment
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Urinary retention is a difficulty urinating in which the bladder does not empty completely, leaving the person with an urge to urinate more times a day, abdominal pain and discomfort, being more frequent in men.

Urine retention can happen due to several situations, such as the presence of stones in the bladder and/or urethra, use of some medications, excessive consumption of alcoholic beverages or changes in the prostate, for example. Thus, it is important that the cause of urinary retention is identified so that the most appropriate treatment can be indicated, which may involve placing a probe (initially) or performing surgery to treat the cause and favor the elimination of urine.

Symptoms of urinary retention

The symptoms of urinary retention are related to the fact that the bladder does not empty completely, which prevents the elimination of all the urine produced. Thus, the main signs and symptoms of urinary retention are:

  • Frequent urge to urinate;
  • Abdominal pain and discomfort;
  • Difficulty urinating;
  • Intermittent stream of urine;
  • Urinary incontinence.

In the presence of these signs and symptoms, it is important that the urologist is consulted so that a detailed physical examination and some laboratory tests such as urinalysis and imaging, such as ultrasound, computed tomography, urodynamic tests and electromyogram can be performed. In this way, it is possible to identify the cause of urinary retention and initiate the most appropriate treatment, preventing the development of complications, such as urinary tract infection, sepsis and renal failure, for example.

Main causes

Urinary retention is most often associated with obstructions in the urinary tract due to the presence of stones, however, other situations that can prevent complete emptying of the bladder are:

  • Urethral constriction/stenosis;
  • Inflammation of the urethra and prostate;
  • Use of medications, such as antihistamines, muscle relaxants, antipsychotics or antidepressants;
  • Neurological changes such as stroke, spinal cord injuries and multiple sclerosis;
  • Urinary tract infection;
  • After urinary tract surgery;
  • Cancer of uterus or prostate.

In addition, in men, urinary retention can occur due to phimosis or benign prostatic hyperplasia, while in women it can be a consequence of uterine prolapse or vulvovaginitis.

How the treatment is done

Treatment for urinary retention should be recommended by the urologist, and it is normally indicated, initially, the placement of a catheter in the bladder to be able to eliminate the urine and relieve the symptoms at the time. Then, more specific treatment is indicated to address the cause of retention.

To treat chronic urinary retention, the urologist may place a probe in the bladder, remove the agent causing the obstruction, prescribe antibiotics in case of an infection, or drugs that promote relaxation of the smooth muscles of the prostate and urethra. If treatment is not effective in relieving symptoms, surgery may be necessary.

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