What causes urinary retention?

Urinary retention can be caused by an obstruction in the urinary tract or by nerve problems that interfere with signals between the brain and the bladder. If the nerves aren't working properly, the brain may not get the message that the bladder is full. Even if you know that your bladder is full, the bladder muscle that squeezes urine out may not get the signal that it is time to push, or the sphincter muscles may not get the signal that it is time to rela . ! weak bladder muscle can also cause retention. Prostate Enlargement: Benign Prostatic Hyperplasia !s a man ages, his prostate gland may enlarge. "octors call the condition benign prostatic hyperplasia #$%&', or benign prostatic hypertrophy. !s the prostate enlarges, the layer of tissue surrounding it stops it from e panding, causing the gland to press against the urethra like a clamp on a garden hose. !s a result, the bladder wall becomes thicker and irritable. (he bladder begins to contract even when it contains small amounts of urine, causing more frequent urination. Eventually, the bladder weakens and loses the ability to empty itself, so urine remains in the bladder. Enlarged Prostate: Causes )ne theory regarding the origin of an enlarged prostate involves the presence of a hormone called dihydrotestosterone #"&(' in the blood. "&( is a natural hormone that is responsible for the initial stages of prostate growth. !s men age, "&( may cause the prostate to continue growing after it has reached full size. *tudies have shown a high positive correlation between "&( levels and enlarged prostate. %hysicians have noted that men who do not produce "&( do not e perience an enlarged prostate. +esearch has also shown evidence that estrogen and genetics may play roles in $%& as well. (he role of estrogen can be e plained by changing levels of testosterone. It is known that men produce testosterone and a small amount of estrogen throughout their lives, with aging, the amount of testosterone in the blood decreases, which leaves a larger proportion of estrogen. *tudies have shown that higher levels of estrogen have been found in men who have enlarged prostate glands. -any physicians believe that genetics play a role as well. -en with a family history of enlarged prostate may be at greater risk than others. It is important to note that the actual size of the prostate does not necessarily denote the severity of the symptoms. .onstriction of the urethra by the prostate may occur in small as well as large glands. It is important to establish the presence of obstruction by clinical testing when considering treatments for symptoms. the size of the prostate gland does not necessarily predict the severity of the enlarged prostate symptoms. ! large gland may not cause any obstruction, and a small gland may cause a lot. &owever, it is known that very large prostate glands almost always cause significant problems. (he portion of the prostate gland that is enlarged can be very significant, for e ample, enlargement involving the median lobe is more likely to be associated with more severe symptoms. In the case of prostates, /ust as in real estate, location matters most.

Enlarged prostate is frequently associated with increased tone in the smooth muscle of the urethra, and many of the irritative symptoms associated with enlarged prostate are due to this increased muscle tone and the resulting interference with urine flow. Infection Infections cause swelling and irritation, or inflammation. ! urinary tract infection #U(I' may cause retention if the urethra becomes inflamed and swells shut. What are the complications of urinary retention? -Urinary Tract Infection Urine is normally sterile, and the normal flow of urine usually prevents bacteria from growing in the urinary tract. 0hen urine stays in the bladder, however, bacteria have a chance to grow and infect the urinary tract. Bladder amage If the bladder becomes stretched too far or for long periods, the muscle may be permanently damaged and lose its ability to contract. Chronic !idney isease If urine backs up into the kidneys, permanent kidney damage can lead to reduced kidney function and chronic kidney disease. If you lose too much of your kidney function, you will need dialysis or a kidney transplant to stay alive. .ause of urinarr retention cause men )bstructive $enign prostatic hyperplasia, meatal stenosis, paraphimosis, penile constricting bands, phimosis, prostate cancer "omen )rgan prolapse #cystocele, rectocele, uterine prolapse', pelvic mass #gynecologic malignancy, uterine fibroid, ovarian cyst', retroverted impacted gravid uterus !cute vulvovaginitis, vaginal lichen planus, vaginal lichen sclerosis, vaginal pemphigus #oth !neurysmal dilation, bladder calculi, bladder neoplasm, fecal impaction, gastrointestinal or retroperitoneal malignancy1mass, urethral strictures, foreign bodies, stones, edema $ilharziasis, cystitis, echinococcosis, 2uillain3$arr4 syndrome, herpes simple virus, 5yme disease, periurethral abscess, transverses myelitis, tubercular cystitis, urethritis, varicella3zoster virus "isruption of posterior urethra and bladder neck in pelvic

Infectious and inflammatory

$alanitis, prostatic abscess, prostatitis

other

%enile trauma, fracture, or laceration

%ostpartum complication, urethral sphincter dysfunction

#6owler's syndrome'

trauma, postoperative complication, psychogenic