Sandhya Raghavan
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Written By: Sandhya Raghavan | Updated : February 17, 2017 4:05 PM IST
Picture this; you have woken up at night with a full bladder. You make a dash for the bathroom and try to relieve yourself. But tonight, you sense something unusual. Despite the full bladder and the terrible urge to pee, not even a single drop of urine passes. Instead you have a searing pain in your lower abdomen and you collapse to the ground. This nightmarish situation seems something right out of a horror movie flick, but in reality, this is a very troublesome condition called Urinary Retention or inability to pass urine despite a full bladder. In this article, Dr Anup Ramani, uro-oncologicalsurgeon from Leelavati Hospital demystifies this nightmarish condition and outlines the course of action for those suffering from urinary retention.
What causes urinary retention?
Whether it is a man or a woman, urine does not dribble out of the bladder. It in fact it is thrown out of the bladder with a considerable amount of force. For the jet of urine to travel, there has to be a force pushing it out, explains the doctor. There are two things necessary for the smooth expulsion of the urine.
Even if one of these things gets affected, the person will experience some trouble in passing urine. There are two main causes why men face bladder retention issues: An enlarged prostate or weak bladder muscles. Although the problem is seen rarely in women, factors such as cervical cancer can contribute towards the condition.
What are the symptoms?
What are the complications?
Treatment options for enlarged prostate
Dr Ramani explains, In men, one of the commonest reasons for urinary retention is a slowly enlarging prostate. The prostate is a gland that surrounds the neck of the bladder and secretes a fluid which constitutes the semen. Think of the gland as a donut-shaped organ. The hole in the centre is meant for the channel that carries urine out of the body, the urethra, says Dr Ramani. After age 50, in many men, the gland starts enlarging in all directions, putting pressure on the urethra and squeezing its opening shut.
Men who start exhibiting early signs of prostate enlargement don t give it too much importance till the day the orifice becomes shut completely.It is then when they decide to visit the urologist, adds Dr Ramani. He continues, We try to drain the patient s bladder with a long, flexible tube called the catheter which is inserted into the urethra. After two weeks of the treatment, the 70% to 80% of the patients are able to pass urine properly since the prostate gets opened. But sometimes, 20%-30% of the patients go back to square one. In such cases, parts of the prostate are surgically removed or laser treatment is given to the patient.
Treatment options for weak bladder
The muscles of the bladder can get weakened due to spine surgery, diabetes, head injuries or paraplegia. Sometimes the signals between the brain and the bladder can be interrupted due to nerve damage and this can render the muscles weak. Because of these problems, the muscles are unable to push the urine out, explains Dr Ramani. But unlike retention arising from an enlarged prostate, this type of retention is practically painless.
"We instruct our patients to manually squeeze the bladder and the abdominal muscles to push the urine out. We also teach our patients self catheterisation, every time they experience bladder problems," reveals Dr Ramani.
How to mitigate the problem?
If early signs are seen, go to the urologist immediately. "A older gentleman who has been my patient for a long time refused medication even after exhibiting clear symptoms of bladder retention. One night, I got a frantic call from his daughter-in-law saying he is in terrible pain. After which he was wheeled into the casualty," recounts the doctor. "Had he taken treatment before, all the hassles and the pain could have been avoided."
Changing faulty lifestyle habits and bringing diabetes under control go a long way in the management of the condition. Dr Ramani says, If you are a male who have crossed 50, for every birthday, give yourself a gift and check for prostate cancer. Undergo two important examinations every year: a sonography to look for an enlarged prostate and a Prostate Specific Antigen test (PSA).
Read this in Hindi.
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