Urinary Retention: Causes, Symptoms, Treatment (PDF)

**URINARY RETENTION** - inability to completely empty the bladder leading to high postvoid residual volume and can be caused by urethral obstruction or bladder paresis ***Postvoid residual volume*** - the amount of urine that remains in the bladder after a person has voided (urinated).  **Associat...

**URINARY RETENTION** - inability to completely empty the bladder leading to high postvoid residual volume and can be caused by urethral obstruction or bladder paresis ***Postvoid residual volume*** - the amount of urine that remains in the bladder after a person has voided (urinated).  **Associated with ** - **Prostate enlargement** (BPH) - **Urethral Trauma** (e.g. strictures) - A**nesthesia** leading to bladder paresis - **Neurologic condition** (e.g. stroke, spinal injury) - **Certain medications such as Anticholinergics and Opioids.** These medications prevent chemicals  from binding to receptor site which prevent the bladder from contracting properly, releasing urine. **CLINICAL FEATURES** - Can be acute (e.g. anesthesia, surgery) or chronic such as with BPH. - Lower abdominal pain, pressure and discomfort due to urine build up in the bladder. - If caused by obstruction, client is going to strain to void. - Decreased urine output - **Overflow incontinence** - Bladder eventually overflow due to being overfilled with urine build up. - **Feeling of incomplete bladder emptying** \-- feeling the need to go to the bathroom in spite the urine build up. - Bladder is firm on palpation, may be displaced from midline when overfilled enough. **COMPLICATION** - **Bladder distension** - displaced bladder from the midline indicates overfilled and swollen bladder and tissues are at risk of injury.  - **Urinary tract infection** - due to injured tissue combined with poooling of urine in the bladder. Prolonged urine build up in the bladder can be a breeding ground of bacteria and may trabel up the ureters int the kidneys causing pyelonephritis. If left untreated, infection may travel to the bloodstream resulting in sepsis. - **Hydronephrosis** - blockage is going to inhibit urine from leaving the body. Pooling of urine and bacterial gwoth may stretch the bladder causing hypertrophy. Retrograde flow of urine may inflame the ureters leading to kidney inflammation and infection. - **Skin breakdown due to urine leakage. Urine is alkaline and uric acid is converted to urea by bacteria on the skin causing quick skin breakdown.** **NURSING INTERVENTIONS** 1. **Promote spontaneous voiding: **Assist client to use bathroom, bedside commode or urinal 2. Provide privacy to encourage relaxation of muscle. 3. Run water in sink or pour water over perineum to promote urination. 4. Oral fluid intake to stimulate body\'s natural reflexes for urination. 5. Monitor Intake and output 6. Bladder scan before and after urination - assess urine volume in the bladder - Normal PVR: 50 - 75 mL 7. Intermitted urinary catheterization if no urine output