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Acute Urinary Retention

Inability to urinate despite urine in the bladder, requiring emergency evaluation.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Üroloji department. Book Appointment →

What is Acute Urinary Retention?

Acute urinary retention (AUR) is a sudden-onset urological emergency characterized by the inability to urinate despite a full bladder, usually accompanied by painful lower abdominal distension. It is most common in men, especially with benign prostatic hyperplasia (BPH); the cumulative lifetime risk exceeds 10% in men over 70.

AUR can develop from bladder outlet obstruction (BPH, urethral stricture, bladder neck contracture, stone, tumor), detrusor muscle dysfunction (neurogenic bladder, spinal cord lesion), pharmacological causes (anticholinergics, opioids, antihistamines), the postoperative period, and infectious/inflammatory conditions (prostatitis, herpes).

Diagnosis is made by clinical findings (painful lower abdominal distension, palpable bladder, no urine output) and bladder ultrasound or portable bladder scanner detecting post-void residual volume >300 mL. Rapid bladder drainage relieves pain and prevents kidney damage.

Symptoms

Sudden inability to urinate
Suprapubic (below the navel) pain and discomfort
Tense and palpable bladder in the lower abdomen
Drop-by-drop urine output with the urge (overflow)
Restlessness and anxiety
Signs of kidney failure in chronic retention
Painless retention in neurological background

Risk Factors

Older age men and benign prostatic hyperplasia
Urethral stricture or previous urethral surgery
Neurological diseases (MS, spinal cord injury, diabetic neuropathy)
Use of anticholinergics, opioids, and some antidepressants
Recent surgery and anesthesia
Pelvic surgery or radiotherapy
Acute urinary tract infection and prostatitis

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Sudden inability to urinate and lower abdominal pain (emergency department)
  • Inability to pass urine despite the urge
  • Distension with continuous drop-by-drop leakage (overflow incontinence)
  • Sudden worsening in known BPH patients
  • Inability to urinate in the first 24 hours after surgery

Treatment Methods

01
Emergency Foley catheter for bladder drainage and decompression
02
Urology consultation and suprapubic cystostomy in difficult catheterization
03
Controlled drainage to avoid hematuria from rapid decompression
04
Investigation of underlying cause: PSA, prostate exam, ultrasound, and cystoscopy if needed
05
Trial without catheter (TWOC) with alpha blocker in BPH
06
Surgical treatment: TUR-P, HoLEP or urethrotomy/urethroplasty for urethral stricture

Which Department to Visit?

You can visit our Üroloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Let us help you

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.