How serious is urinary retention - and can it be treated?

While many of us will experience this occasionally, if it’s becoming a familiar and frequent issue for you then it could be caused by a condition called ‘urinary retention’. 

Urinary retention, or UR, can quietly affect women as we don’t experience as many symptoms as men do. Unfortunately, this can mean that there is little to no signs of UR occurring until it becomes severe and if left unmanaged, can lead to leaks and incontinence. 

What is Urine Retention?

Urinary retention happens when the bladder doesn’t empty completely. It can occur suddenly (acute) or develop gradually (chronic). 

Acute Urinary Retention comes on quickly, leading to an inability to urinate despite a full bladder. AUR can be very painful and requires urgent medical attention to avoid any further problems. It’s worth noting that AUR is less common in women, affecting around 3 in 100,000 of us as opposed to 1 in 10 men over the age of 70.

However, there is another form of urinary retention which is less severe, called chronic urinary retention. This occurs due to incomplete emptying and can often develop slowly with few symptoms. If the bladder doesn’t fully empty, urine is left behind - called ‘residual urine’. This residual urine makes it easier for bacteria and germs to grow and possibly increase the risk of urinary tract infections. 

Recognising the symptoms of Urinary Retention

Symptoms vary based on whether retention is acute or chronic. Signs to watch for include:

• Inability to start urinating or empty the bladder fully

• Weak urine stream or dribbling after urination

• Frequent need to urinate, sometimes as often as every two hours including during the night

• Pressure or discomfort in the lower abdomen

• Difficulty passing urine, which may feel strained

• Not passing any urine for hours 

For acute retention, severe pain can occur as the bladder fills but doesn’t empty. If you notice any of these symptoms, particularly discomfort or frequent urination, seeking medical advice is essential. It’s important to bear in mind that the symptoms of urinary retention can mimic those of other conditions, such as overactive bladder (i.e. needing to pee frequently) . It's important to get a proper assessment to determine the exact cause of your symptoms.

What Causes Urinary Retention?

There are various causes of urinary retention - and understanding these can potentially help to manage the risk of UR occuring. 

Obstructions in the urinary tract: Bladder stones, fibroids, or an enlarged uterus can press on the bladder or block urine flow, especially during pregnancy or with certain gynaecological conditions.

Weak pelvic floor muscles: Pelvic floor weakness, often linked to childbirth or ageing, can hinder the bladder’s ability to empty fully.

Nerve issues affecting bladder control: Conditions like diabetes, spinal injuries, and multiple sclerosis can disrupt bladder nerve signals, making it harder to coordinate contractions in the bladder.

Infections and inflammation: Urinary tract infections (UTIs) and bladder inflammation can temporarily interfere with urination, potentially leading to retention.

Medication side effects: Certain medications, such as those for blood pressure, allergies, or anxiety, may affect bladder function, reducing the ability to urinate fully.

Diagnosing Urinary Retention

There are various ways to diagnose urinary retention. You may have a physical examination and be referred for a bladder ultrasound by your GP. Urodynamic studies can help to measure the bladder function, including pressure and urine flow to check if there are any potential issues with muscle or the nerves. You may also have a cystoscopy, which examines inside your bladder to check for blockages and abnormalities. 

In the first instance, you should speak with your GP who can recommend an appropriate pathway after assessing your symptoms and concerns. 

How is Urinary Retention treated?

Treatment for urinary retention will depend on the cause. There are several options that can help relieve the symptoms of UR from pelvic floor exercises to surgery: 

Pelvic floor exercises are often recommended for chronic retention due to pelvic floor weakness. These can strengthen these muscles, supporting better bladder control. 

Medications may be prescribed to relax bladder muscles or reduce inflammation if infections contribute to retention. 

Catheterisation is a common treatment for acute retention, providing immediate relief by draining the bladder. For chronic cases, intermittent catheterisation may help reduce risks associated with incomplete emptying.

Surgery may be necessary if a physical blockage is present. For example, fibroids or other growths pressing on the bladder can be removed to restore normal urine flow.

Look after your bladder

Supporting bladder health is essential to reducing the risks associated with urinary retention. Staying hydrated, doing pelvic floor exercises, and seeking medical advice at the first signs of symptoms can help. If you are concerned that you are noticing changes to your pee habits, or your bladder health, try keep a Bladder Diary to monitor your symptoms and discuss with your GP.

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