Conditions: Urinary Retention after Surgery

 

What is a Urinary retention?

Urinary retention is the inability to completely empty the bladder. The inability to urinate despite having a full bladder can lead to stretch of the bladder wall and, in severe cases, other problems. Urinary retention sometimes occurs after a procedure performed under general anesthetic.

The urine outflow tract from the bladder passes through the prostate in males. An enlarged prostate may block urinary outflow.

Who is at risk of urinary retention after surgery?

Age: The risk of postoperative urinary retention doubles in patients older than 60 years. This is true for men and women, but men with an enlarged prostate gland are especially at risk.

Medications: Certain medications used during surgery increase the risk of postoperative urinary retention by a variety of mechanisms. General anesthesia lasting more than to hours and spinal anesthesia increase risk of urinary retention.

How is urinary retention after surgerY identified?

  Symptoms of urinary retention include the following:

    • Feeling like you need to urinate but being unable to urinate

    • Feeling like you have not fully emptied your bladder after urinating

    • Feeling pain in the low abdomen

Typically, if one is able to urinate normally and completely once after surgery, the risk of urinary retention thereafter is low. If symptoms of urinary retention develop, you may need to present to an Emergency Room where a bladder scan to verify urinary retention and possibly catheterization to empty your bladder may be performed.

How is urinary retention after surgery treated?

A urinary (“Foley”) catheter is placed through the urethra into the bladder and the retention balloon near the tip of the catheter is inflated only AFTER reaching the bladder. The catheter drains urine into a bag. Click image to enlarge it.

Ideally, first-line efforts such as a medication or various psychological tricks may help. Medications, such as Flomax, may help men with large prostrate glands urinate after a few doses. Tricks include placing a hand in warm water or listening to running water in the sink while trying to urinate. If these efforts fail, a urinary catheter may need to be placed to relieve the stretch on the bladder wall. If the bladder distention becomes severe, the bladder may temporarily lose its ability to contract, in which case the catheter must be left in place for about a week for the bladder to recover. The bag may be wrapped around a leg and hidden under pants, allowing for driving and walking in public. Arrangements are made for the catheter to be removed by a urologist in clinic. In extreme cases, if a catheter is not placed and if the bladder ruptures, surgical repair may be necessary.