Why do you want to go to the toilet, but urine does not go. Acute urinary retention in men

Urination is a completely natural act in which excess fluid and metabolic products are excreted from the body. Any disturbances in this process can signal the development of problems in the activity of the urinary system and other parts of the body. If you ignore urination disorders, they may well worsen, and the diseases that provoked them can become chronic and especially neglected, hardly giving in to further treatment. Let us clarify why urinary retention can occur in men, we will discuss the treatment and causes of this phenomenon.

Urinary retention is a fairly common symptom that many men have to deal with. Its cause may lie in the influence of a variety of factors and in the development of various health problems. Accordingly, the treatment of such a disorder may differ.

Causes of urinary retention in men

There are quite a few factors that can provoke urinary retention in the stronger sex. True, it is worth recognizing that most often such a problem is provoked by the presence of prostatitis - an inflammatory lesion of the prostate gland, or a benign formation develops in the prostate gland - prostate adenoma in men.

Much less often, urinary retention is due to other factors. Among them, there may be diseases associated with the activity of the genitourinary system - stone formation in the bladder, prostate cancer, symptoms of tumor lesions of the urethra, etc. Also, such a symptom can provoke diseases of the central nervous system, for example, myelitis, problems in the activity of the spinal cord or brain.

Sometimes urinary retention in men is due to drug intoxication. Sleeping pills and narcotic substances can act as aggressive medications.

In some cases, urinary retention occurs after surgery on the genitals or on the rectum. In addition, it can be provoked by severe stress and a state of intoxication.

How is urinary retention corrected in men, what is its effective treatment?

If urinary retention is acute, and the patient is completely unable to urinate, even with a strong urge to urinate, treatment should begin with diversion of urine from the bladder. At the same time, doctors can carry out catheterization of the bladder - insert a rubber or metal tube into it through the urethra, after which urine is excreted.

A cystectomy may also be performed. In this case, doctors make a small puncture of the skin above the bladder and insert a rubber tube into its cavity.

Further therapy depends on the factor that caused urinary retention.
So the correction of prostatitis is carried out using antibiotics and symptomatic agents - analgesics and antispasmodics. Rectal suppositories or thermal microclysters are often used. After the acute symptoms subside, they resort to physiotherapy, massage, etc.

With an adenoma of the prostate that causes urinary retention, doctors most often raise the question of the need for surgical intervention. Surgeons may perform a transurethral resection of the prostate (TURP) by removing prostate tissue through the urethra. An open surgical procedure, called a prostatectomy, can also be performed.

In some cases, specialists can also advise minimally invasive methods for reducing the volume of prostate adenoma, for example, microwave thermotherapy, cryodestruction, and laser exposure. In addition, balloon dilatation of the urethra (expansion of the lumen of the urethra with the help of a special catheter) and stenting of the prostatic urethra (expansion of the lumen of the urethra by introducing a stent into it) can be performed.

If urinary retention is caused by a stone in the bladder or urethra, it is necessary to eliminate the stone formation. For this purpose, the formations are crushed, after which they are excreted from the body.

Malignant and benign tumors that can cause urinary retention are most often eliminated by surgery. If necessary, appropriate treatment can be carried out: chemotherapy, radiation therapy, etc.

If urinary retention is caused by reflex factors, it is quite easy to correct. To eliminate this problem, antispasmodics, sedatives and adaptogens can be used.

Other methods of therapy are selected exclusively by the doctor on an individual basis. Self-medication is not indicated, since urinary retention in the absence of adequate correction can be complicated by acute renal failure, acute pyelonephritis, acute cystitis, gross hematuria, etc.

Folk remedies

For many men suffering from urinary retention, not only medicines, but also traditional medicine methods can be useful. So healers advise patients with such a problem to use birch leaves, the medicinal properties of which improve the condition with urine diversion. Thirty grams of crushed and dried vegetable raw materials, brew a liter of boiling white wine. Boil this mixture for a quarter of an hour under the lid, then let it cool and strain. Sweeten the finished medicine with honey and drink it in a third of a glass three times a day about an hour after a meal.

Even patients with urinary retention may need a medicine that can be prepared from rose hips - its tincture. In this case, it is worth using the fruits of this plant - chop them well and remove the bones from the raw materials obtained. Fill a glass bottle halfway with rose hips, and then fill it to the top with vodka. Leave the medicine to infuse in a dark place for one week. Do not forget to shake the prepared tincture from time to time. Take ten drops of it, dissolving this amount in a tablespoon of water. Take it twice a day shortly before meals.

The feasibility of using traditional medicine should be discussed with your doctor.

Disturbed work of the genitourinary system is one of the most common pathologies that affects the organs of older men and often flows into a chronic form. Acute urinary retention in men can be caused by diseases of the prostate glands, prostate adenoma.

The disease in question can appear in children, women, but according to statistics, it is men who are most often violated. Such a deviation during urination in medicine is called - ischuria.

Urinary retention on x-ray

With acute urinary retention, a person experiences some inconvenience, not only because he cannot completely empty the urinary tract, but also because the output of urine becomes discontinuous and sore. In this regard, the question arises of how urinary retention occurs in men and its treatment. Next, we will answer it.

Such a disease over time acquires an acute form, and after a while it becomes chronic.

Discomfort with such a deviation will increase each time, the urea output will not be complete, while the urge to go to the toilet will be constant.

Patients have the following types of pathology:

• aggravated ischuria - progresses rapidly and causes pain in the abdominal cavity, then you can feel a sharp desire to empty, however, when going to the toilet, the patient will have difficulty urinating;
• chronic urinary retention;
• acute retention or paradoxical ischuria - occurs due to fluid incontinence.

The reasons

The causes of urinary retention in men can be of two types:

• mechanical;
• disturbances in the functioning of the nervous system.

The mechanical causes of fluid suspension are represented by the following factors:

• or ;
• urinary tract injuries;
• in the urinary tract;
• malignant tumors in the intestines that put pressure on the urethra;
• narrow foreskin that prevents the opening of the glans penis;
• acquired or congenital abnormalities in the urethra;
• infectious diseases of the genitourinary system that cause swelling in the urethra.

Disorders of the nervous system, as the causes of the outflow of urea:

• malignant tumors in the brain;
• herbs of the brain and spinal cord;
• destruction of tissues of nerve endings (demyelinating abnormalities);
• the use of certain medications (injections, the use of prophylactic drugs and dietary supplements after surgery);
• stress, overwork;
• constant use of alcoholic beverages;
• immobility for a long time (physical inactivity).

What does a tumor look like on an x-ray?

signs

Suspension of urine can be confused with other pathologies, such as anuria - at the same time, there is no urine in the bladder, but there is an urge to go to the toilet.

Acute

With this manifestation of the disease, the patient feels increased pain during urination. The abdominal cavity is in great tension, touches become especially painful.

Chronic

Symptoms do not appear too sharply, however, some painful sensations can be observed. At the same time, ischuria escalates to very severe pain when trying to outflow urine.

The exit of urine is very difficult, there is no normal pressure, the process is interrupted all the time. Older men may experience incontinence. Often develops on the background of prostate adenoma.

As soon as the patient feels such symptoms, he needs emergency help from a qualified doctor. It is the specialist who can identify the exact factors in the appearance of the disease, and determine the therapy of the pathology.

Diagnostics

To accurately diagnose ischuria, ultrasound is used as a search for causes in impaired work. If there are above observed symptoms, such methods of studying the nature of the disease are used, such as:

1. x-ray;
2. cystoscopy;
3. general blood and urine tests;
4. examination of the prostate gland (for prostate adenoma).

Bladder on x-ray

First aid

Many factors provoke urinary retention. At the first symptoms, to get rid of pain, you can take No-Shpu, according to the instructions.

But you need to understand that this analgesic does not cure pathology, but only eliminates pain. You can not drink it often, as the medicine is addictive. To avoid complications, be sure to consult a doctor.

With especially acute manifestations, emergency care is needed. To do this, you should undergo an examination by a specialist or call an ambulance.

Treatment

Urinary retention in men, its causes and treatment may vary depending on the final diagnosis.

In acute suspension of urine, a catheter is used as a treatment. It is inserted into the urethra and thus urine is excreted. If such therapy is not possible, then a smaller catheter is used. Antibiotics are prescribed as additional treatment.

To treat the chronic form, the specialist eliminates the underlying cause of the disorder. If this is a mechanical damage, then, most often, surgical intervention is used.

Prevention

Urinary retention in men usually develops in old age. This is due to the fact that the immune system weakens, and it is more easily exposed to external influences of negative factors.

On the other hand, ischuria can also appear in younger men due to an unhealthy lifestyle: drinking alcohol, a poorly balanced diet.

If a disease is suspected, it is necessary to go to the appropriate specialist without delay. Having determined the degree of development and its variety, he will prescribe the necessary treatment.

A very unpleasant condition that can occur in a man is the impossibility of emptying the bladder naturally. He is full of urine, but for some reason it lingers in him, does not come out through the urethra. The medical term for this disorder is called ischuria. There are several forms of urinary obstruction, which differ in the peculiarity of manifestation. It mostly affects men, more often in old age. Why and what to do when urine does not leave? The answer to the question of interest can only be given by the treating specialist. In case of acute pain associated with urination, an ambulance is called, urgent hospitalization is required.

The function of the genitourinary system is responsible for collecting and removing urine from the body:

Urine does not pass

• the kidneys filter the blood, remove excess fluid and other substances;
• the ureters transport urine to the bladder;
• The bladder is the reservoir that transports urine to the urethra for excretion.

The urinary reservoir holds 350 ml. liquids. Normally, the period between outgoing urine is 2 to 5 hours, depending on the fluid consumed. When a man’s body is healthy, during urination, the muscle fibers of the bladder receive a signal, they relax, and emptying occurs unhindered.

Varieties

Urinary retention is called ischuria, there are several types:

• chronic (complete, incomplete).
• acute (complete, incomplete).

Each proceeds in its own way.

1. At the initial stage, chronic ischuria can not be felt, developing it acquires characteristic noticeable symptoms. If a person fails to urinate himself, for this he is inserted into the urethra, they do not use it for a long time, only a few days. A patient with a chronic incomplete form can empty himself, but urine is not excreted and remains in the urinary reservoir, increasing the patient's stomach.
2. Acute urinary retention in men has such a name because it manifests itself unexpectedly, it is accompanied by pain in the lower abdomen, in the bladder, it overflows and the person has a constant urge to excrete urine. The acute incomplete form is characterized by a small release of urine.
3. Paradoxical ischuria. In this type of disease, there is a strong stretching of the bladder. The patient is unable to urinate on his own, urine automatically drops out of the urethra.

All forms of the disease are equally dangerous for human health, especially since it is not always possible to detect symptoms in time.

It is highly undesirable to delay the visit to the urologist, otherwise complications arise:

• peritonitis;
• urogenic sepsis;
• renal failure, colic;
• urinary rupture.

Calling for medical help is a must.

Alarms

The first thing to watch out for is:

With such symptoms, an ambulance is called, which will provide the necessary actions or hospitalization will be made. To relieve pain, you can put rectal suppositories with papaverine, a warm heating pad, but in no case refuse qualified help. The general condition may improve, the problem associated with urinary retention will remain.

Influencing factors

The causes of urinary retention in men depend on numerous factors and the age of the patient, the most common are:

The normal patency of urine is affected by:

• pathological process in the central nervous system;
• trauma, damage to the brain of the head and back;
• performed operational actions on the spinal column, peritoneum;
• excessive use of alcohol, drugs;
• long-term use of medications (hypnotics, sedatives, antidepressants);
• hypothermia, stress, strong physical exertion.

Be sure to pay attention to the sensations during the withdrawal of urine, urinary incontinence, even the slightest tingling should alert especially the elderly. Often urine is retained in men due to diseases occurring in organs near the genitourinary system, for example, phimosis, prostate sclerosis, inguinal hernia, rectal cancer.

Diagnosis

Urinary retention in men exerts psychological and physical pressure, especially when the patient does not sound the alarm when obvious symptoms are detected. To identify all the concomitant factors affecting this problem and exclude complications, the doctor examines the history, examines the patient, and based on these data, an additional study may be prescribed:

• Ultrasound of the bladder, prostate.
• X-ray.
• Cystoscopy.
• X-ray of the lumbar crus.
• CR, MRI of the brain.

Be sure to pass a general analysis of urine and blood. Patients who have crossed the forty-year milestone are recommended to examine the prostate gland once a year and do a PSA analysis to detect adenoma at an early stage.

Therapeutic actions

The treatment process takes place on the basis of the results of analyzes and diagnostics:

• Emergency care includes the withdrawal of accumulated urine from a man using a catheter.
• Next, the underlying disease that led to the retention of urine is eliminated.
• Anti-inflammatory and antibacterial drugs are used.
• Surgical intervention.

Difficulties urinating affect:

• on sexual desire;
• potency;
• erection.

Therapy is prescribed by the treating specialist, his recommendations should be taken seriously. In this case, you should not rely on folk remedies, they will not solve the problem itself; their effectiveness has been proven on initial deviations in health. They have no effect on advanced forms of the disease. Cooked decoctions and herbal infusions can be used as an addition to the main treatment, but it is better to ask your doctor for advice. If urine in men comes out with a delay, this is a symptom of another developing pathology in the body. Damage, trauma of the urinary tract is eliminated surgically. The main thing is not to wait out the alarming symptoms, but to remove them in time, intoxication of the body leads to a complication of the disease.

Preventive actions

Urinary retention in men causes and treatment is always individual.

To avoid such a problem, you need to monitor your health:

• undergo annual examinations, especially for men after forty, at this age there are more chances of developing prostatitis and adenoma;
• also in the cold season, dress warmly and not overcool;
• do not abuse alcohol;
• in time to treat chronic renal, genitourinary, diseases.

Once faced with urinary retention and ignoring the pathology, in the future the problem can be aggravated by unpleasant complications. Which, if not carried out any action will turn into an incurable disease. Men of mature age also need to take care of their health, try to do not hard physical exercises and be sure to visit a urologist. Against the background of chronic and acquired diseases, there are problems with urinary retention. Don't be negligent about your health.

• urolithiasis as a result of blockage of the urinary tract;
• narrowing of the foreskin;
• existing hematomas, aneurysms in the pelvic area;
• infectious diseases;
• inflammation of the prostate, the foreskin of the head of the penis;
• injury to the urethra or bladder.

• An effective way to clean the kidneys at home

Additional symptoms may include:

• bleeding, discharge of blood clots;
• a tumor in the bladder, prostate gland, in other organs in the pelvic area;
• congenital abnormal structure of the urinary system, preventing the outflow of urine;
• inflammation, damage to the urethra, which led to a narrowing of the lumen in it;
• prostate adenoma, which is considered the most common disease in men.

Urinary retention can be neurogenic in nature and appear when:

• multiple sclerosis;
• injuries of the spinal cord, brain;
• severe intoxication with alcohol, drugs, in case of an overdose of sleeping pills;
• hypothermia of the body;
• severe and frequent stress;
• inability to empty the bladder in a timely manner due, for example, to the lack of a toilet (urinary retention becomes arbitrary over time).

Often interfere with urination if a man has:

• prostatitis;
• stones in the bladder or urethra;
• prostate adenomas;
• phimosis;
• tumors;
• prostate cancer;
• diseases of the central nervous system in the form of injuries in the spinal cord or brain.

An acute condition associated with a delay in emptying the bladder is possible if a person is intoxicated with alcohol, under stress, hysteria, after surgery on the rectum, perineum, as a result of a long stay of a man in bed, as well as drug intoxication.

Possible causes of difficulty urinating

Sudden interruption, or acute urinary retention, is most often observed with prostate adenoma in men over the age of 60-65 years. Also with a sedentary lifestyle, frequent diarrhea or constipation, when the gland experiences a strong rush of blood. The delay is characteristic of prostate adenoma: urine does not pass completely, painfully, with blood, the patient has a fever, the temperature rises. Pelvic fractures, urethral injuries also provoke urinary retention.

Acute urinary retention in men can have a peculiar form: first, urine departs, then suddenly interrupts, while the bladder remains not completely empty. This is a clear symptom that there are stones in the bladder that block the opening of the urethra or urinary canal. When the position of the patient changes, urination can be adjusted and continued. If urinary retention becomes a constant phenomenon, the muscular walls of the bladder and sphincter are gradually stretched, involuntary discharge of urine is possible in droplets, in small portions.

Acute urinary retention is accompanied by pain in the groin, pain during urine outflow, urge. It is necessary to catheterize the bladder with a rubber catheter and treat the disease based on the diagnosis, identifying the initial causes that led to such a disease.

Treatment Methods

As already mentioned, the underlying disease that the patient has leads to urinary retention. Men need to undergo a thorough examination. After making a diagnosis, the doctor will select a treatment, prescribe anti-inflammatory, antibacterial drugs. The introduced catheter minimizes the acute course of the disease, alleviates the patient's condition. But this manipulation is one-time, then you need to eliminate the underlying disease through drug treatment. Additionally, treatment can be carried out with folk remedies.

If the outflow of urine is disturbed for mechanical reasons, surgical intervention is possible. If the disease is associated with inflammatory infectious processes in the body, antibiotics, sulfonamides are prescribed.

It is possible to sew a special implant to the wall of the bladder, which will become a stimulator for normal muscle contraction in the urethra, which will improve the outflow of urine, make it regular and complete.

Folk remedies

Folk remedies are not able to cure the underlying disease, but serve only as an addition to drug therapy, are able to relieve unpleasant painful symptoms, and alleviate the general condition of the patient. It is useful to take tea rose fruits infused with alcohol, decoctions of juniper bark, rosehip infusion for alcohol, walnut shells ground into powder or infused with alcohol. Before self-treatment, it is better to first consult a doctor, otherwise you can aggravate the situation without knowing the real cause of the disease.

Urinary retention is a consequence of another pathology that develops in the body, to detect and identify which in a timely manner means to get rid of side symptoms in the form of a delay, a painful condition of the urethra.

It will help in alleviating the symptoms if the fruits of the tea rose are poured with water or alcohol, insisted for several days before acquiring a straw-yellow hue. Take this remedy should be 10 drops 2 times a day, after diluting the composition with a small amount of water.

You can grind the bark, walnut leaves into powder, take 8-10 g 2-3 times a day with warm boiled water.

You can grind dry birch leaves, pour dry white wine (1 l), boil the mixture for 20-25 minutes, then cool and strain. Add 3 tbsp. l. honey, take 3 times a day after meals for 1/3 cup.

It will help if you grind the rose hips, put them halfway in a glass bottle, pour vodka, keep for 7 days in a dark place, shaking occasionally. The finished tincture should acquire a light brown hue, you need to take it 10 drops 2-3 times a day, 1 tbsp. l. half an hour before meals.

In the acute phase, with urinary retention, duckweed in a powdered state helps well. Take 3 times a day before meals, 1 tbsp. l., drinking water.

• IMPORTANT TO KNOW! Prostatitis is the cause of 75% of male deaths! Don't wait, just add 3 drops to the water..

Urinary retention in men requires a diagnosis of the entire genitourinary system. Urine is taken for analysis by removing it from the bladder through a catheter, a swab from the urethra, blood for the presence or exclusion of infection in the urethra, ultrasound of the ureter and bladder in case of weakened muscles, CT, MRI for nervous disorders of the spine or brain. Perhaps the doctor will prescribe a cystomy by a small puncture over the bladder and the introduction of a rubber tube to ensure a full outflow of urine, or the introduction of novocaine, proserpine, pilocarpine into the urethra.

Treatment of urinary retention, or ischuria, should be carried out by competent specialists who are able to choose the right methods for resuming the outflow of urine and getting rid of problems associated with urination.

Treatment of urinary retention in men. There are several causes of urinary retention that can affect a man's sexual activity.

Urinary retention in men

Urinary retention is that there is no way to empty the bladder from it. Such phenomena can be chronic in men. At the same time, a feeling of discomfort can manifest itself in the fact that there is no normal pressure during urination, and not all urine comes out immediately. You will want to go to the toilet quite often, but still the outflow of fluid will occur. When acute retention occurs, urine will not come out at all. Chronic retention of urine excretion from the body contributes to disruption of the entire body and requires special treatment.

Urinary retention can occur in both sexes. But treatment on this occasion is more observed in men, especially in middle age, after 45 years. This is due to the possibility of developing diseases of the prostate gland. At this age, there is a risk of prostate adenoma. Now experts use the name - prostatic hyperplasia. In women, this may be due to the fact that the pelvic muscles cannot hold the internal organs, so they sink. The probability of such phenomena is observed after 40 - 50 years.

Regardless of gender, there is the possibility of urinary retention in case of injuries, especially the nerve endings that are responsible for this function in the body.

urinary system of the body

The genitourinary system is the tissues and organs that are responsible for collecting and expelling urine in the body. The kidneys are able to filter the blood, removing excess fluid and other substances. The ureters are designed to transport urine to the lower organs of the genitourinary system, namely the bladder. It acts as a reservoir, which then transports urine into the channel for its excretion.

In an adult, the bladder can hold up to 350 ml of urine. The normal period between urination is 2 to 5 hours. This will depend on its fullness and the amount of liquid consumed.

To prevent voluntary urination, the muscle fibers of the bladder are in a compressed state, they are called sphincters. Through the nerve endings, signals are sent to the brain that the bladder is already full and needs to be released. Moreover, if there is a limit on the amount of liquid, it becomes necessary to urgently visit the toilet. If the whole system is working properly, then at the time of urination, the sphincters will receive a signal and relax, and the bladder muscles will contract. It is at this point that urination occurs. If the whole procedure goes smoothly - urine freely leaves the body. In this process, the main role is given to the muscles of the bladder and sphincters. If there is a delay in the excretion of urine from the body, a consultation with a urologist is necessary, while treatment is carried out on an outpatient basis or in a hospital.

Causes of urinary retention in the body

Urine may be retained in the body due to trauma to the organs of the genitourinary system or disruption of the functioning of all stages of fluid excretion.

Complex diseases can lead to such consequences:

• Infectious diseases of the spinal cord or brain;
• Diabetes;
• Received injuries of the spinal cord or brain;
• stroke or multiple sclerosis;
• Injuries in the area of ​​the organs of the genitourinary system;
• Accumulation of heavy metals in the body;
• Congenital pathologies of the genitourinary system;
• Diseases that occur in the prostate gland.

Middle-aged men are at risk due to the possibility of prostate diseases. With the course of the inflammatory process or the formation of a tumor, the prostate increases. The size of the gland may increase in the direction where the urethra is located. Therefore, with an increase in the prostate in size, a narrowing of the channel through which urine is excreted from the body occurs. With age, the muscles of the bladder weaken, and they are not able to produce the necessary contractions. Because of this, urine will linger in the body.

If the infection enters the organs of the genitourinary system, an inflammatory process begins. During this period, the sphincters may swell and the excretion of urine will be difficult.

The quality of urine excretion from the body can be affected by the use of medications.

Urinary retention can occur when taking:

• Allergy medications;
• Antispasmodics;
• Antidepressants.

Stones in the bladder

One of the most common causes of urinary retention can be bladder stones. This can happen unexpectedly, even at the time of urination. The jet will be interrupted due to the fact that the stone may be in the bladder and move freely in the fluid. Therefore, a situation is possible when it blocks the outflow. Stones are formed due to retention of urine in the bladder, most often if this happens often.

In this case, urinary retention is chronic. This is facilitated by cystitis, and in men, diseases of the prostate. The mucous membrane of the bladder swells and the outflow of urine is difficult.

In the case of the formation of stones, the treatment will be to carry out medical procedures that can save the patient from them. To do this, use the contact method of endoscopy or ultrasound.

Symptoms

With exacerbation of diseases of the genitourinary system, urinary retention will be accompanied by pain, quite severe. The patient wants to go to the toilet, but is unable to do so. The lower abdomen swells and the pain may increase when touched.

If urinary retention occurs constantly, then the sensations will become a little dull. But the discomfort will always be there. The patient has difficulty urinating. Have to strain the muscles and press on the lower abdomen. The extraction process may stop and the pressure will be very weak.

It feels like the bladder is not fully emptied. Therefore, the desire to go to the toilet will appear very soon. Such manifestations create certain problems and can affect the quality of life. The patient needs frequent visits to the toilet and stay in it for quite a long time.

medical examination

To find out the cause of urinary retention in men, you need to conduct a special examination, the treatment will depend on this.

After 40 - 45 years old, a specialist will definitely suggest examining the prostate. With urinary retention, prostate adenoma is very often diagnosed. They also do urine and blood tests. To prepare for surgery, the patient is prepared according to a special scheme.

The main methods of examination:

• Examination of the bladder using ultrasound. This method is carried out with a full bladder;
• Examination of the prostate using ultrasound, which allows you to fully examine the prostate and identify any pathologies;
• Performing a urinary test. The patient must consume a certain amount of fluid and at the same time it is necessary to record the amount of urine excreted from the body. The rate of excretion of urine from the body is determined. A urodynamic study is essential in diagnosing the cause of urinary retention.

As directed by a urologist, X-rays and cystoscopy may be performed.

Treatment

If a man has acute urinary retention, he can be helped by using a catheter. It is installed through the urethra, but there are cases when this cannot be done. In this case, a drainage system is installed.

With chronic urinary retention, it is necessary to find out the cause, the type of treatment will depend on this.

To restore urination with a narrowing of the urethra in men, surgical intervention is necessary. Three methods are used - conventional surgery or endoscopy. The bougienage method consists in using a special device with which the urethra expands. But experts say that when using bougienage, scars on the urethra may appear, and this may reduce the effectiveness of treatment.

In cases with the course of the inflammatory process in the prostate gland, the urologist may prescribe medication or surgery. The choice of treatment will depend on the individual characteristics of the organism and is carried out according to the doctor's prescription.

Difficulty urinating with prostatitis affects sexual function in men. The potency, attraction will decrease and erectile dysfunction occurs.

For any reason for difficulty urinating, you can use herbal medicine in combination. But this necessarily requires agreement with the attending physician. It is recommended not to self-medicate and not to use drugs in large quantities.

Any manifestations associated with a violation of urine output in men need a detailed examination in order to identify the cause. Delaying a visit to a urologist can lead to serious consequences and significantly harm your health. This can lead to the formation of oncological tumors, which are much more difficult to treat.

Urinary problems in men, especially in adulthood, are quite common. In modern medical language, the condition is called ischuria. Urinary retention in men often leads to severe psychological and physical discomfort. At the same time, the health of the representative of the stronger sex and the general state of his health are deteriorating. Complications arising from untimely treatment of the disease are of great danger. The pathology that causes urinary retention in a man must be eliminated in a timely manner, which is the key to a successful outcome. Therefore, it is important to realize how important emergency care is in some cases, although in some cases, planned therapy is sufficient. More details about all the features of the pathology will be described below.

Classification of pathology

Depending on the rate of development, ischuria is divided into:

• Sharp. Acute urinary retention in men develops suddenly. Pathology is accompanied by a detailed clinic: pain in the lower abdomen, frequent urge to urinate, a feeling of incomplete emptying of the bladder. At first, a small amount of urine, straining, a man can excrete, but later the urine ceases to be excreted completely. Acute ischuria is a dangerous condition that requires emergency medical intervention.
• The chronic process often proceeds without a detailed clinical picture. In most cases, a man does not notice the presence of a problem until a certain time. When the degree of obstruction (closing of the lumen of the urinary tract) or narrowing reaches a critical level, the symptoms begin to weigh on the person, and he turns to the doctors.

The classification of pathology reflects the degree of urinary retention. Complete is characterized by the absolute impossibility of excretion of urine. When a patient seeks emergency care, doctors use a catheter to remove the urine. Incomplete delay can accompany a man for a long time and go unnoticed.

The main signs of the condition: the need to strain when urinating, a feeling of incomplete emptying of the bladder, intermittent urination or excretion of urine in the form of drops.

There is another, special type of urinary retention - paradoxical ischuria. The name of the pathology comes from the presence in the mechanism of development of a kind of paradox, when the bladder overflows with urine, the walls of the organ stretch, but the man cannot empty himself voluntarily. At the same time, urine from the urethra is secreted involuntarily drop by drop.

Reasons for development

Ischuria has various causes and mechanisms of occurrence. Pathology can develop as a result of:

Damage to the organs of the urinary system.

· Violations of the normal outflow of urine, causing blockage of the urinary tract.

· Compression of the urethra.

In most cases, difficulty urinating in men occurs with prostate adenoma.

Acute urinary retention can occur in men at different ages. Symptoms develop rapidly. The causes can be trauma to the brain or spinal cord, degenerative diseases of the nervous system (multiple sclerosis) and other ailments of the central nervous system that cause dysfunction. Urination disorder often occurs in the postoperative period after interventions on the spine, abdominal organs.

Male ischuria can be the result of poisoning with drugs, sleeping pills or alcohol. Some drugs can also lead to a lack of urine output: diphenhydramine, oxybutine, antidepressants, doxepin, antihistamines (anti-allergic) can cause an illness. Sometimes urine stops being excreted as a result of hypothermia, after stress or physical overexertion.

Chronic pathology develops more often in elderly men against the background of long-term ailments of the urinary system. Prostate tumors, including benign hyperplasia, localized in the bladder or any other part of the urinary apparatus, can cause dysuric disorders. The development of difficulties with urination in hyperplasia is associated with the gradual compression of the urethra by the enlarging gland. And if the first symptoms of dysuria are imperceptible, then over time they increase, and the lack of treatment can lead to acute urinary retention.

Tumors, sclerosis, fibrosis and inflammation of nearby organs, such as the rectum, can lead to pathology. Neurogenic bladder dysfunction, which is more common in older men, can cause a chronic disorder.

Detection of pathology: how it manifests itself

Symptoms of urinary retention, in principle, are understandable. The main manifestation is a violation of the normal function of the urinary tract. In the acute form of the disease, the symptoms are more pronounced, as urine stretches the walls of the bladder, causing pain. Pain can also be felt in the projection, where the closure of the urinary tract has occurred, for example, with a stone. Additionally, symptoms of a pathology that led to an acute delay are sometimes observed. If the pathology was caused by an injury, then a man may complain about the discharge of blood or blood clots from the urethra, the damage is sometimes determined visually.

The doctor prescribes treatment for difficulty urinating only after examination and identification of the cause.

With an acute delay, a man feels an irresistible desire to urinate, but there is no urine output. A person may try to excrete urine by pressing on the lower abdomen, straining the muscles of the anterior abdominal wall: sometimes these techniques cause the release of a small amount of urine, but not complete emptying.

If the difficulty arose against the background of inflammation, then the man complains of periodic or constant pains of a aching, cutting nature in the lower abdomen, in the lumbar region. With balanitis or balanoposthitis, the doctor will notice external changes in the genital organs. When BPH causes chronic retention, other signs of prostatic hyperplasia are often present:

The need to urinate frequently.

Sensation of incomplete emptying of the bladder.

Sluggish urine stream.

The need to urinate at night.

In the absence of medical care, with an acute delay, a rupture of the bladder and intoxication of the body with harmful products can occur. If the bladder ruptures, the signs of complications will resemble the clinic of the "acute abdomen", that is, there will be symptoms of peritoneal irritation. A man will be disturbed by sharp pains, body temperature rises, intoxication increases.

To make a diagnosis, it is enough for a man to complain about the lack of urine output. Diagnostic search should be aimed mainly at finding the causes of urinary retention. A man is usually prescribed the following diagnostic procedures:

Urinalysis (during acute and complete retention, urine is drained by a catheter).

In order to exclude infectious diseases, the urologist takes blood from a vein and a urethral swab from a man.

· Ultrasound examination of the bladder and prostate.

· Urodynamic tests. With their help, the doctor will determine the rate of excretion of urine, the contractility of the bladder and its sphincter, the residual amount of urine.

Cystoscopy (internal examination of the bladder wall with a special instrument - a cystoscope).

Computed tomography or magnetic resonance therapy of the abdominal organs.

In a number of situations, it is necessary to determine the causes of the pathology very urgently in order to start treating a man on time. Otherwise, the delay may be complicated by rupture of the bladder, acute peritonitis, etc., and sometimes lead to the death of a person.

Methods for eliminating pathology

In the event of acute urinary retention in men, emergency symptomatic treatment is used - bladder catheterization. Measures are taken to alleviate the patient's condition and prevent complications. A flexible elastic tube - a catheter - is inserted into the lumen of the urethra, it is advanced until it enters the bladder and the subsequent exit of urine by gravity. If it is impossible to eliminate the delay, a cystostomy can be applied to a man - a thin tube installed above the pubic bone.

Radical treatment of a chronic or acute condition is prescribed only after examination and identification of the cause.

The introduction of a catheter is a one-time manipulation that relieves the symptoms of the disease for a short time and prevents the development of complications. The main treatment for urinary retention is carried out depending on the causes that caused it, and is aimed at eliminating the underlying disease.

Therapy of the main causes of delay:

• Neurogenic dysfunction is eliminated by “suturing” a special implant that stimulates the contraction of the muscles “necessary” for urination.
• In infectious processes, drugs with antibacterial activity are prescribed - antibiotics.
• In the presence of mechanical obstacles to the outflow of urine, surgical intervention is resorted to.
• If urinary retention is caused by an adenoma, a man is prescribed drugs from the alpha-adrenergic blocker group, for example, a drug called Omnic. The drug acts on the smooth muscles of the prostate and urinary tract relaxing, which leads to easier excretion of urine.

Alternative methods should be used in combination with drugs.

To eliminate chronic urinary retention in men, in particular with prostatic hyperplasia, treatment with folk remedies can be used. It should be remembered that natural preparations should be used in combination with basic medicines. Traditional medicine offers the following useful recipes that can help with urinary retention:

• Ingestion of an alcohol tincture from the fruit of a tea rose. For cooking, you need to insist the fruits on medical alcohol. Take the remedy for 10 cap. 2 r.day, adding them to 100 ml of pure water. Treatment must be agreed with the attending physician.
• Decoction of juniper bark.
• Alcoholic infusion of rose hips.
• Walnut shell tinctures.

It must be remembered that home self-treatment can be harmful to your health, and is allowed only after a full examination and medical consultation. In men, urinary retention does not occur spontaneously against the background of complete health, but is a sign of a developing pathology. Timely detection of the problem and a visit to the doctor is a sure guarantee of your health now and in the future.

Urinary retention in men is a pathological condition in which it becomes impossible to urinate in the presence of urine in the bladder, while maintaining an intense urge to urinate (exceptions - spinal injury, neurological pathology).

Classification

The following variants of ischuria (urinary retention) are possible.

1. Acute ischuria. It develops rapidly, within a few hours. A man feels pain in the lower abdomen, a sharp urge to urinate, but he cannot urinate.
2. Chronic ischuria - urination is possible and seems to be carried out, but a certain amount of urine remains in the bladder, which should not be during a normal act. With this form, there is no acute urge to urinate.
3. Separately, paradoxical ischuria can be distinguished - with an overflowing bladder, urinary incontinence appears. This is due to overstretching of the valves in the urethra.

Causes of urinary retention

Outflow difficulties due to mechanical obstructions

• prostate tumors, both benign and malignant;
• urethral injury;
• stricture (narrowing) of the urethra;
• stones in the bladder or urethra;
• tumor of the urethra;
• tumors of the rectum, squeezing the urethra;
• phimosis - the narrowness of the foreskin, which does not allow the head to open completely;
• congenital anomalies in the development of the urethra (valve or hypertrophy of the seminal tubercle);
• infections of the genitourinary system, causing a sharp swelling and narrowing of the urethra.

Difficulty in outflow due to disorders of nervous regulation

Neurological diseases due to which inhibition or lack of impulse to the bladder occurs:

• neoplasms of the spinal cord or brain;
• spinal cord injury due to trauma;
• demyelinating diseases (destroying the sheaths of nerve cells).

In addition, impulse transmission may be delayed with certain medications.

Transient inhibition of the nervous system and, as a result, urinary retention can cause:

• stress, fear, any strong emotion;
• alcohol intoxication;
• surgery on the organs of the abdominal cavity or small pelvis;
• prolonged immobility (lying patients).

Symptoms of urinary retention

First of all, you need to be able to distinguish urinary retention from anuria - a pathology in which urine is absent in the bladder, and therefore there is no way to urinate.

Acute urinary retention

The patient feels severe discomfort, pain that comes from the place of obstruction (blockage) of the urethra. There is an irresistible desire to urinate a little, but it does not work out. The abdomen becomes tense in the lower sections, sharply painful when touched.

Possible manifestation of acute urinary retention.

Chronic urinary retention

As mentioned above, there is no pain and no urge to urinate. But there are some uncomfortable sensations that are constantly debilitating. The very act of urination is difficult, while the man strongly strains the abdominal press. And sometimes you have to press on the lower abdomen in order to urinate. All these actions do not facilitate the process, the urine stream goes under low pressure and is often interrupted. After there is no feeling of emptying the bladder, which causes new attempts to urinate.

If you have any of these symptoms, you should immediately seek the help of a specialist. Only an experienced doctor will be able to confirm the diagnosis, prescribe a treatment that is right for you.

Diagnosis and treatment

For accurate diagnosis, ultrasound of the bladder is used.

When identifying characteristic symptoms, additional studies are used:

• Ultrasound of the bladder and prostate;
• x-ray with contrast agent;
• bladder cystoscopy.

In addition, a man must pass general blood and urine tests.

For men over 40 years of age, the condition of the prostate gland must be examined, including an analysis for PSA (a tumor marker that makes it possible to detect adenoma in the early stages).

First aid at home

As a first aid for urinary retention, take no-shpu.

With acute urinary retention, you need to urgently call an ambulance. In anticipation of it, you can try to improve the outflow yourself. "Home remedies" are usually aimed at relaxing the smooth muscles of the urinary tract, which can, at least partially, restore the flow of urine.

• take no-shpu, best in the form of a rectal suppository (or put suppositories with papaverine);
• a warm (not hot!) shower aimed at the lower abdomen;
• sometimes a cleansing enema helps.

Despite how effective these measures have been, it will be necessary to consult a doctor. Indeed, despite the improvement in the condition, the cause of urinary retention remains unresolved.

Treatment for acute and chronic urinary retention will differ.

acute form

In the acute form, bladder catheterization is most often used: a flexible catheter is inserted through the urethra, through which stagnant urine exits. In some cases, the installation of a catheter is not possible, then a special drainage system is installed, the tube in which is noticeably thinner. After the outflow of urine is restored, the disease that caused its delay is treated.

Chronic form

If ischuria has taken a chronic course, then first you need to eliminate the cause that disrupts the outflow of urine. If this is caused by mechanical reasons, then this can be corrected with the help of surgery or the use of an endoscope, which can identify the cause of the outflow disturbance. Most often, a violation of the outflow of urine is caused by prostate adenoma. Its treatment can be both surgical and medical. The doctor will choose the tactics of treatment.

Complications

One of the complications of chronic urinary retention is cystitis.

Acute urinary retention can cause overdistension and rupture of the bladder. Perhaps the development of acute renal failure due to the fact that the kidneys "nowhere" to filter urine.

With chronic retention, complications often appear due to the multiplication of pathogenic flora in "stagnant" urine:

• cystitis;
• pyelonephritis.

Prevention

All activities aimed at urinary retention can be described as taking care of your own health:

• timely diagnosis and treatment of infections;
• avoidance of excessive alcohol consumption;
• annual visit to the urologist after reaching the age of 40;
• regular blood donation for PSA;
• if changes in urination occur while taking medications, immediately inform the specialist who prescribed them;
• avoid injury to the urethra.

It is the inability to empty the bladder. With chronic urinary retention, when you want to urinate, you may have a problem with an adequate fullness of the stream or bladder emptying. You may also experience frequent urination or a feeling of incomplete emptying of the bladder. In this case, one way or another, urination is preserved and the outflow of urine occurs. In the case of acute urinary retention, you cannot urinate at all, even though your bladder is full. The presence of chronic urinary retention, in addition to discomfort, also leads to serious disorders of the whole organism.

It occurs at any age, both in men and women, but men over 50 years of age are most susceptible to this problem, the cause of this is a disease - benign prostatic hyperplasia or prostate adenoma. A woman may experience urinary retention when her bladder sags due to weakness in the pelvic floor muscles of the diaphragm and moves out of its normal position through the vagina, a condition called a cystocele. By analogy with a cystocele, a rectocele can also form (in case of sagging of the large intestine), which can also cause urinary retention. Diseases associated with weakness of the pelvic floor muscles are more common in people older than 40-50 years. The function of normal urination may be impaired in individuals with damage to the nerves that conduct nerve impulses that provide the urge to urinate.

What is the urinary tract?

The urinary tract is made up of organs and tissues that work together to produce, store, and drain urine from the body. The upper urinary tract includes the kidneys, which filter and remove excess fluid and waste products from the blood, and the ureters, which transport urine from the kidneys to the lower urinary tract. The lower urinary tract is represented by the bladder. The bladder is a muscular fibrous reservoir that serves as a reservoir for storing urine. From the bladder, urine enters the urethra. Normally, the bladder holds 250-350 ml of urine. And the time between urges to urinate is from 2 to 5 hours, depending on the fluid you drink.

Spontaneous outflow of urine from the bladder is prevented by circular muscles, which are located on the border with the bladder and urethra. These muscle fibers are called the bladder sphincter. The sphincter tightly closes the walls of the urethra, thereby preventing the spontaneous outflow of urine.

The walls of the bladder contain special nerve receptors that signal the need to urinate if it is full. The first urge to urinate occurs when the bladder is filled up to 150-200 ml, then, if you do not urinate, the sensation may become somewhat dull. The second more pronounced urge occurs when urine is filled up to 300-350 ml. As urine accumulates in the bladder, the urge becomes stronger. Such a sensation is provided to us by a complex reflex arc, and all the links of this chain act as one mechanism.

During urination, the brain signals the sphincter muscles to relax while the bladder muscles contract. The combination of the normal functioning of the bladder sphincter muscles and the muscles of the bladder contributes to the unhindered exit of urine through the urethra when you want it.

What are the causes of urinary retention?

Urinary retention may be due to mechanical disorders, the so-called. obstruction of the urinary tract or functional disorders at the level of nerve fibers. The lack of normal activity on the part of the nervous system leads to the fact that the sphincter muscles work inadequately (relaxed or tense), which is manifested by incontinence or urinary retention, and disorders of the nervous system can lead to a lack of urge to urinate or normal contraction of the bladder.

Nervous disease or spinal cord injury

Some conditions can cause damage to nerves and nerve pathways. Some of the most common reasons are:

• natural childbirth
• infections of the brain or spinal cord
• diabetes
• stroke
• brain or spinal cord injury
• multiple sclerosis
• heavy metal poisoning
• pelvic injuries
• congenital neurogenic disorders of the detrusor-sphinter apparatus of the bladder (appear in childhood)

Urinary retention due to prostate enlargement

As a man grows older, his prostate gland may increase in size, a condition called benign prostatic hyperplasia (BPH), benign prostatic hypertrophy, or prostate adenoma.

Enlargement of the prostate occurs both to the sides and inward towards the urethra. To make this process easier to understand, we can draw an analogy with some kind of fruit. For example, if you do not pick an apple from a tree and make a through hole in it, then the whole apple will look like a prostate, and the hole will look like a urethra (urethra). If you leave the apple to ripen for several weeks, then the apple will increase in size, while the channel inside will become narrower. A similar process occurs with the prostate and the canal within it. The hyperplastic lobes of the gland compress the canal more and more as the man grows older. As a result, compensatory mechanisms are activated - the muscles of the bladder are forced to strain with great effort to expel urine. However, over time, decompensation of the muscles of the bladder occurs, and they are no longer able to contract normally, which is manifested by symptoms of urinary retention.

Urinary retention due to urinary tract infection

The infection causes swelling, irritation, or inflammation of the tissues. Urinary tract infections (UTIs) can cause urinary retention if the urethra becomes inflamed and the bladder sphincter swells.

Urinary retention while taking medication

There are drugs that are prescribed to slow down the transmission of nerve impulses. A side effect of some is urinary retention.

Drugs that can cause urinary retention:

• antihistamines to treat allergies
• fexofenadine
• diphenhydramine
• chlorpheniramine
• cetirizine
• anticholinergic/antispasmodic drugs for relief of abdominal cramps, muscle spasms
• hyoscyamine
• oxybutynin
• tolterodine
• propaneline
• tricyclic antidepressants to treat anxiety and depression
• imipramine
• amitriptyline
• nortriptyline
• doxepin

Urinary retention with bladder stone

A stone in the bladder often causes urinary retention. In this case, you will have a sudden stop of the stream, since a stone floating freely in the bladder does not always block the outflow of urine. The reason for the formation of a stone in the bladder may in turn be urinary retention (usually chronic). The presence of a stone in the bladder is associated with the appearance of frequent recurrent cystitis, which in turn leads to swelling of the bladder mucosa, including its neck, which in turn further aggravates the normal outflow of urine.

A cystocele occurs when the wall between a woman's bladder and her vagina weakens, causing the bladder to sag and even protrude through the vagina. On the part of the act of urination, this condition is accompanied by urinary incontinence or urinary retention.

Urinary retention with urethral stricture

Urethral stricture is a narrowing of the lumen of the urethra as a result of a scarring process due to an infection, injury, or surgery. This pathology is more common in men.

What are the symptoms of urinary retention?

Acute urinary retention causes severe discomfort and acute pain in the place where the blockage of the urinary tract occurred. You feel an irresistible urge to urinate, but it is not possible to do so. The lower abdomen is tense and painful when touched.

Chronic urinary retention does not cause severe discomfort or pain in the womb, but this feeling is constant and debilitating. Difficulty initiating urination is present, and it often occurs after tensing the abdominal muscles or with manual pressure on the lower abdomen. After the start of urination, the urine stream is weak and may be interrupted. After urination, there is often a feeling of incomplete emptying of the bladder, which necessitates a second attempt to urinate after a short period of time. In addition to functional disorders, a number of psychological problems and complexes develop, associated with the need to urinate frequently and for a long time.

What examinations are carried out with urinary retention?

After a detailed conversation with you, the doctor will prescribe a series of tests and examinations to establish the correct diagnosis.

If you are a man older than 40, your doctor will suspect an enlarged prostate due to the growth of an adenoma. This disease occurs in 50% of men over 50 years of age. That is, every second man over 50 is diagnosed to some extent with an increase in prostate adenoma.

From laboratory tests, the doctor will prescribe clinical and biochemical blood and urine tests, PSA (if you are a man over 40 years old). The operation will require additional tests.

Conducted instrumental examinations include:

• Ultrasound examination of the bladder with the determination of residual urine after urination. Therefore, before this procedure, it is necessary to have at least 200 ml of urine in the bladder.
• An ultrasound examination of the prostate gland is performed to determine the size, shape, consistency, confirmation or exclusion of prostate adenoma and other pathologies.
• urodynamic tests. There are a large number of urodynamic tests that allow you to determine the speed of urination, the contractility of the sphincter and bladder, the amount of residual urine, determine the level of damage to nerve fibers, etc. Urodynamic tests allow you to find out the cause of urinary retention and its severity. Without a urodynamic examination, it is not possible to make a correct diagnosis, and, accordingly, the correct treatment.
• If necessary, cystoscopy, X-ray studies, etc. are performed.

Urinary retention treatment

In acute urinary retention, treatment begins with drainage of the bladder using a urinary catheter. A flexible catheter is inserted into the bladder through the urethra. However, placement of a catheter is not always possible. Then there is a need to install a special drainage system in the form of a cystostomy. The cystostomy is a thin tube that is placed 2 cm above the pubic symphysis.

In the case of chronic urinary retention, treatment is carried out depending on the cause of the disease.

Treatment of urinary retention in cystocele and rectocele

In women, when the bladder is prolapsed and protruded, an operation called colpopexy is performed. This operation is performed from a small incision on the anterior wall of the vagina. This technique is possible with the use of a special prolene network, which in the future will play a supporting role for the bladder and uterus.

Treatment of urinary retention in urethral stricture

In general, there are two ways to treat urethral strictures: endoscopic and open surgery. The choice of treatment method depends on the length of the stricture and its location. We do not recommend bougienage of the urethra, as this leads to scarring of the urethra and only reduces the chances of successful treatment.

Treatment of urinary retention in prostate adenoma

Depending on the stage of the disease, the size of the prostate, and your age, your doctor will recommend medical or surgical treatment.

There are a large number of drugs, among which alpha-blockers and 5-alpha reductase inhibitors have the greatest effectiveness against prostate adenoma.

To date, this type of treatment is the "gold standard" for the treatment of prostate adenoma.

The article is informational. For any health problems - do not self-diagnose and consult a doctor!

V.A. Shaderkina - urologist, oncologist, scientific editor