Urinary retention
Urinary retention, also known as ischuria, is an inability to completely empty the bladder. It is a common complication of benign prostatic hyperplasia (BPH).
Cauda equina syndrome usually produces urinary retention, although sometimes urinary incontinence may occur (some cases are overflow incontinence).
Etiology
Etiologies of urinary retention:
1. bladder outlet obstruction (a brief differential diagnosis list is presented here)
a) urethral stricture:retention tends to be progressive over time
b) prostatic enlargement in males:
● benign prostatic hypertrophy (BPH) & prostate cancer: retention tends to be progressive over time
● acute prostatitis: onset of retention may be sudden
c) women: bladder or vaginal prolapse which can produce a urethral kink
d) obstructing thrombus from hematuria(clot retention)
e) bladder calculi
f) bladder or urethral foreign bodies
g) urethral cancer:rare
2. detrusor areflexia or hypotonia
a) spinal cord lesion
● trauma
● tumor
● myelomeningocele
c) medications: anticholinergics, narcotics
d) diabetes mellitus (autonomic neuropathy)
e) herpes zoster at the level of the sacral dorsal root ganglia