Urinary retention is the inability to completely empty the bladder. A patient with urinary retention may be unable to start urination, or if he is able to start, he cannot fully empty his bladder. There is a common misconception that urinary retention only occurs in men. This is not true. Urinary retention is not peculiar to men. It can occur in both genders.
The causes of urinary retention could be obstructive or non-obstructive. Obstructive causes include bladder stones, enlarged prostate, prostate cancer, bladder neck stenosis (narrowing), bladder cancer, meatal stenosis, phimosis, paraphimosis, urethral cancerand urethral strictures. These all have the potential to stop the flow of urine. There are several obstructive causes. Non-obstructive causes include bladder atony (loss of bladder tone; flabby bladder) usually due to diabetes, past surgical operations around the bladder with loss of nerve impulses, chronic urinary retention from other causes with damage to the bladder and eventual loss of tone even if the initial cause of retention has been addressed. Nerve problems are also non-obstructive causes, they usually arise from spinal cord compression or injury, as well as autonomic neuropathy (which is how diabetes causes loss of bladder tone).
The cause of the obstruction generally determines the mode of treatment. For obstructive causes such as bladder stones or urethral strictures, there are minimal access surgery procedures that could resolve the issue. Often, these procedures could be done without leaving any wound on the body. Non-obstructive causes such as weak bladder muscles can sometimes be treated surgically by reducing the size of the bladder.
The symptoms of bladder outlet obstruction from enlarged prostate include:
- Hesitancy(the need to wait a little while in the bathroom before urine starts running)
- Poor Stream
- Intermittency(a situation where urine stream stops suddenly by itself even when the bladder is not empty, then starts again)
- Terminal Dribbling
- Feeling of Incomplete Voiding
- Frequency(having the need to pass urine less than 2 hours after having previously voided)
- Nocturia (a condition when the individual has to wake up at night to pass urine)
- Urgency (a situation when one cannot postpone voiding due to overbearing pressure. One would even try to force a car or bus driver to stop so as to give the chance to void)
- Urge Incontinence(when the urine actually comes out by itself before one gets to the bathroom)
Talk to your doctor about your symptoms and how they affect your daily life. Your doctor will make a diagnosis based on your symptoms.
Patients can be classified into those who do not need treatment, those who need medical treatment and those who need surgery. This classification becomes easy once symptom scores are analyzed by aUrologist, and once tests like urine tests, scans and uroflowmetry are done. These are all available in Kelina Hospital. For patients with enlarged prostate, we do both bipolar Transurethral Resection of the Prostate(TURP) and Holmium Laser Enucleation of the Prostate, using the most powerful surgical laser in the world, the 120 Watts Lumenis Laser (Moses Technology). Ours was the first of this laser in the African continent.
For stones, we do laser lithotripsy. We have 7 different approaches to stones. All are minimally invasive procedures. Patients tend to go home the same day or the next day after these procedures. Usually, there is no wound on the body. All the patients have their meals the same day, and can return to work 2 or 3 days after discharge from the hospital.