Acute urinary retention (AUR) is a serious and often alarming condition that requires immediate medical attention. It occurs when the bladder is unable to empty, leading to intense discomfort and a sense of urgency. While it may seem like an isolated problem, acute urinary retention is often a symptom of an underlying health issue. Understanding its causes, triggers, and available treatment options is critical for anyone experiencing this condition, especially since untreated AUR can lead to complications such as bladder damage, kidney problems, and even permanent incontinence.

In this article, we’ll explore what causes acute urinary retention, the common triggers you shouldn’t ignore, and how it is treated. 

What is acute urinary retention?

Acute urinary retention (AUR) is a sudden and painful inability to urinate despite feeling the urge to do so. This condition can be incredibly distressing and may lead to symptoms such as:

• Failure to pass urine despite strong urges
• Severe lower abdominal pain or discomfort
• Swelling or bloating of the abdomen
• The feeling of fullness in the bladder

Unlike chronic urinary retention, which develops gradually over time, acute retention comes on suddenly and requires immediate treatment. In most cases, AUR is a medical emergency, and failure to address the problem quickly can result in complications such as bladder distention, infections, or even permanent damage to the bladder or kidneys.

What is the most common cause of acute urinary retention?

Acute urinary retention (AUR) is a sudden inability to urinate, often caused by underlying health issues. AUR is a disease that needs a medical emergency and can caused by a variety of factors, from physical obstructions to neurological problems that affect bladder function. Here are the most common triggers:

1. Benign prostatic hyperplasia (BPH)

In men, BPH, or benign prostatic hyperplasia, is a leading cause of AUR. The prostate enlarges and obstructs the urethra, making it difficult for urine to pass. BPH is more common in older men and can worsen over time, leading to acute retention if left untreated.

2. Medications

Certain medications can interfere with bladder function. Alfusin tablet (Alfuzosin HCL), an alpha-blocker used for BPH, can help relax the bladder and prostate muscles. However, it may cause side effects like dizziness or low blood pressure, which can worsen urinary retention in some individuals. Other medications with anticholinergic properties, like antihistamines and antidepressants, can also hinder bladder contractions, leading to retention.

3. Urinary tract infections (UTIs)

UTIs can irritate and inflame the bladder, sometimes obstructing urine flow and leading to AUR. This is especially common in women due to their shorter urethras. Left untreated, a UTI can cause further complications, including acute retention.

4. Neurological conditions

Diseases like spinal cord injuries, multiple sclerosis, or strokes can disrupt the brain-bladder connection, causing neurogenic bladder. This can prevent the bladder from contracting properly, leading to urinary retention.

5. Post-surgical complications

Surgeries, particularly in the abdominal or pelvic regions, can trigger temporary urinary retention due to anaesthesia or nerve damage. Medications like opioids can exacerbate the problem by slowing bladder function. Most cases resolve in a few days, but persistent symptoms may require further intervention.

6. Bladder stones or obstructions

Bladder stones, tumours, or other physical blockages can obstruct urine flow and cause AUR. Larger rocks or growths may completely block the urethra, causing a backup of urine in the bladder.

7. Constipation

Severe constipation can put pressure on the bladder, leading to difficulty urinating. This is particularly true in chronic constipation, where the distended bowel may compress the bladder, triggering AUR symptoms.

8. Dehydration

Dehydration can result in low urine output and bladder irritation, worsening retention. Ensuring proper hydration helps maintain normal urinary function and prevents complications like AUR.

What are the diagnosis and treatment of acute urinary retention?

Acute urinary retention is diagnosed based on a thorough medical history and physical examination. In most cases, your doctor will need to perform a catheterisation procedure to relieve the bladder and assess the volume of urine remaining in the bladder after an attempt to urinate. 

Additional tests such as blood work, imaging, and urine cultures may also be required to identify the underlying cause.

Once the cause of the retention has been identified, treatment will depend on the specific trigger. In cases of BPH, medications may be prescribed to relax the muscles around the bladder and prostate, making it easier to pass urine.

For infections, antibiotics are often necessary, while surgery or catheterisation may be needed to remove obstructions or address structural issues.

How to prevent acute urinary retention?

While acute urinary retention is sometimes unavoidable, there are several steps you can take to decrease the risk of developing this condition:

• Manage underlying health conditions: Treating conditions such as BPH, diabetes, and neurological disorders can help prevent retention.
• Stay hydrated: Drinking enough water each day makes sure your bladder functions properly.
• Practice good urinary habits: Avoid holding in urine for long periods and empty your bladder fully when you urinate.
• Avoid constipation: Maintaining a healthy diet rich in fibre and staying active can help prevent constipation-related urinary retention.
• Be cautious with medications: If you're taking medications with anticholinergic effects or alpha-blockers like Alfuzosin, talk to your physician about possible side effects and monitoring.

Wrapping up

Acute urinary retention (AUR) is a serious condition that requires immediate medical attention. Its triggers range from benign prostate enlargement to neurological disorders and urinary tract infections. 

Early recognition and therapy can prevent complications and improve quality of life. If you're experiencing symptoms of urinary retention, consult a healthcare provider promptly. If prescribed medications for conditions like BPH, follow your doctor’s guidance to manage symptoms and minimise side effects. Maintaining good bladder health through preventive care is essential for long-term well-being.