Urinary retention has no synonyms
Urinary retention is the inability to empty the bladder completely. Urinary retention can be acute or chronic. Acute urinary retention happens suddenly and lasts only a short time. People with acute urinary retention cannot urinate at all, even though they have a full bladder. Acute urinary retention, a potentially life-threatening medical condition, requires immediate emergency treatment. Acute urinary retention can cause great discomfort or pain. Chronic urinary retention can be a long-lasting medical condition. People with chronic urinary retention can urinate. However, they do not completely empty all of the urine from their bladders.
Urinary retention can be caused by several problems, such as obstruction of the urethra, problems related to the central nervous system, medications, and weakened bladder muscles. Obstruction of the urethra causes urinary retention by blocking the normal urine flow out of the body. Conditions such as benign prostatic hyperplasia can cause an obstruction. Urinary retention can result from problems with the nerves that control the bladder and sphincters. Many events or conditions can interfere with nerve signals between the brain and the bladder and sphincters. If the nerves are damaged, the brain may not get the signal that the bladder is full. Even when a person has a full bladder, the bladder muscles that squeeze urine out may not get the signal to push, or the sphincters may not get the signal to relax. Various medications can also cause urinary retention by interfering with nerve signals to the bladder and prostate. A few of these medications include certain antihistamines, antispasmodics and certain antidepressants.
Urinary retention can be treated in a variety of ways, including bladder drainage, urethral dilation, urethral stents, prostate medications and surgery. The type and length of treatment depends on the type and cause of urinary retention.
Bladder drainage involves catheterization to drain urine. Treatment of acute urinary retention begins with catheterization to relieve the immediate distress of a full bladder and prevent bladder damage. The health care provider passes a catheter through the urethra into the bladder. In cases of a blocked urethra, he or she can pass a catheter directly through the lower abdomen, just above the pubic bone, directly into the bladder. In these cases, the health care provider will use anesthesia.
Urethral dilation treats urethral stricture by inserting increasingly wider tubes into the urethra to widen the stricture. An alternative dilation method involves inflating a small balloon at the end of a catheter inside the urethra.
Another treatment for urethral stricture involves inserting an artificial tube, called a stent, into the urethra to the area of the stricture. Once in place, the stent expands like a spring and pushes back the surrounding tissue, widening the urethra. Stents may be temporary or permanent.
The last resort for treating urinary retention is prostate surgery. To treat urinary retention caused by benign prostatic hyperplasia, a urologist may surgically destroy or remove enlarged prostate tissue by using the transurethral method. Removal of the enlarged tissue usually relieves the blockage and urinary retention caused by benign prostatic hyperplasia.
Once urinary retention has been diagnosed with the help of physical exams and medical tests such as cystoscopy, CT scans and electromyography, the doctor then decides the appropriate method of treatment for the patient, depending upon his/her type of urinary retention, and the causes behind it.
Urinary retention is different from other urinary issues, and if the problem is resolved by medications prescribed by the urologist, then no further specialized treatment is necessary.
Treating urinary retention can often have some side effects, such as urinary tract infections, bladder damage, kidney damage, and urinary incontinence, especially after surgery.
Urine is normally sterile, and the normal flow of urine usually prevents bacteria from infecting the urinary tract. With urinary retention, the abnormal urine flow gives bacteria at the opening of the urethra a chance to infect the urinary tract. Also, If the bladder becomes stretched too far or for long periods, the muscles may be permanently damaged and lose their ability to contract. Additionally, in some people, urinary retention causes urine to flow backward into the kidneys. This backward flow, called reflux, may damage or scar the kidneys.
Since urinary retention is treated using various different methods, each method has separate post-treatment guidelines. In case of bladder drainage and urethral dilation, post-operative treatment generally includes the patient being instructed on how to self-catheterize to drain urine as necessary. For treatment via prostate surgery, the patient has to stay in hospital for a couple of weeks. For the first week the patient urinates via the catheter, following which he can urinate on his own. Physical activities requiring wide range of motion are prohibited for up to a few months after the surgery.
Depending on the type of treatment, recovery can take anywhere between two days to several months. In case of prostate surgery, full recovery can take up to 6 months.
Depending on the type of treatment, the price can range from Rs. 10,000 to Rs. 8,00,000
In case of acute urinary retention, a single drainage of the bladder is able to successfully treat urinary retention. However, in case of chronic urinary retention, the patient has to keep coming back to have their bladder drained, in which case the treatment is a chronic one. If prostate surgery is involved, then the results are always permanent.
Rs. 10,000 - Rs. 8,00,000
Urinary incontinence is the unintentional passing of urine. It's a common problem thought to affect millions of people. There are several types of urinary incontinence, including:
It's also possible to have a mixture of both stress and urge urinary incontinence.
What causes urinary incontinence in men?
Urinary incontinence in men results when the brain does not properly signal the bladder, the sphincters do not squeeze strongly enough, or both. The bladder muscle may contract too much or not enough because of a problem with the muscle itself or the nerves controlling the bladder muscle. Damage to the sphincter muscles themselves or the nerves controlling these muscles can result in poor sphincter function. These problems can range from simple to complex.
A man may have factors that increase his chances of developing UI, including
UI is not a disease. Instead, it can be a symptom of certain conditions or the result of particular events during a man’s life. Conditions or events that may increase a man’s chance of developing UI include
Treating Urinary Incontinence
Initially, your GP may suggest some simple measures to see if they help improve your symptoms. These may include:
In medical terms, the pelvic floor refers to a group of muscles in the pelvic area. These muscles provide support to the organs in the pelvic region, including the bladder, uterus (women), prostate (men) and rectum.
What is pelvic floor dysfunction?
This is a medical condition that is used to refer to a situation when you are unable to control the functioning of the pelvic floor. It means you fail to control the bowel movement. People suffering from pelvic floor dysfunction use these muscles to contract rather than to relax. It is for this reason that they cannot have a bowel movement. They often have an incomplete one.
What causes pelvic floor dysfunction?
In most of the cases, the exact reason behind this dysfunction is unknown. It is often believed that this condition is caused due to traumatic injuries to the pelvic area. This can happen after an accident and due to complications aroused after vaginal childbirth.
What are the symptoms?
There are several symptoms that are linked to this medical condition. You must visit your doctor if you come across the following signs:
How is pelvic floor dysfunction diagnosed?
It may be diagnosed through a physical examination by the doctor. You will ask several questions to know the case history and find out the cause. You may also be asked to take pelvic muscle control test by placing surface electrodes on the perineum or sacrum. A small device called a perineometer is also used for the same.
What are the best ways for treating pelvic floor dysfunction?
It can be treated without surgery. There are several techniques. Some of these are as follows:
Pelvic Floor Dysfunction results in Urinary Dysfunction. Urinary incontinence is the unintentional passing of urine. It's a common problem thought to affect millions of people. There are several types of urinary incontinence, including:
It's also possible to have a mixture of both stress and urge urinary incontinence.
Pelvic organ prolapse is a condition in which structures such as the uterus, rectum, bladder, urethra, small bowel, or the vagina itself may begin to prolapse, or fall, out of their normal positions. Without medical treatment or surgery, these structures may eventually fall farther into the vagina or even through the vaginal opening if their supports weaken enough. If you wish to discuss about any specific problem, you can consult an urologist and ask a free question.
Your uterus is held in place by ligaments, tissues and pelvic muscles. The prolapse occurs when the ligaments or muscles weaken, and thus they can no longer support the uterus. The uterus slips or sags from its usual position into the birth canal (vagina).
Uterine prolapse could be complete or incomplete:
Type of Prolapse:
Uterine prolapse can be caused by any of the following factors:
Symptoms of uterine prolapse depend on its severity. There are no symptoms or signs if you have mild uterine prolapse. But if you have moderate to severe uterine prolapse, you might experience the following symptoms:
Symptoms might feel less distressing during the morning, but they worsen at night.
An individual's inability to empty the bladder, completely, through urination is known as urinary retention. People of all age groups and genders suffer from urinary retention. However, it is more common in 50- or 60-year-old men. The causes vary according to the types of urinary retention.
The causes behind the two types of urinary retention are different.
Any type of blockage restricts urine to flow through the urinary tract. The reasons behind this are:
Improper functioning of nerves and weakened bladder muscles may lead to this condition. The reasons behind this are:
There are various methods of treating urinary retention at home though they are all limited care measures. Sitting in a bathtub filled with warm water helps relax the pelvic floor muscles. Another method is self-stimulation for urination by using running water in the bathroom. Limited mobility might be one of the primary reasons for urinary retention. Hence, daily walking or exercising not only helps facilitate urination but also helps strengthen the pelvic muscles. Women suffering from mild Cystocele or Rectocele are advised to exercise every day to prevent urinary retention.
Certain food items are also unsuitable for people suffering from urinary retention. Therefore, the patient is recommended to avoid or reduce the intake of spicy food, citrus fruits, and foods containing artificial sweeteners. Also, the intake of packaged items needs to reduce to help cure urine retention. The physician often advises the patient on dietary changes along with some exercises that help strengthen the pelvic muscle and thus help cure the disease quickly. Moreover, adoption of a healthy lifestyle goes a long way to help treat urinary retention.
It is advised not to delay the visit to a doctor, once the patient knows that he/she is suffering from the symptoms of urinary retention. If it is a serious case, then surgery is the only cure.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Multimodal pain management has become an important part of the perioperative care of patients undergoing total joint replacement. The principle of multimodal therapy is to use interventions that target several different steps of the pain pathway, allowing more effective pain control with fewer side effects. Many different protocols have shown clinical benefit. The goal of this review is to provide a concise overview of the principles and results of multimodal pain management regimens as a practical guide for the management of joint arthroplasty patients.
Multimodal denotes administering two or more than two types of medications that work with different mechanisms. The following are the techniques used:
Pre-operative Femoral Nerve Block: Prior to the surgery, a catheter is placed beside the femoral nerve for blocking it. This nerve is located in the upper thigh. Medication is delivered through the catheter for the nerve to be numbed for 24 hours. Thus, pain signals to the brain are blocked. This method reduces the use of narcotics and the consequent side effects.
Patient Controlled Analgesia (PCA): This method is also known as ‘Pain Pump’. An intravenous pump is used to administer pain relief medications, such as oxymorphone or morphine, after the surgery. The control button of the machine could be pressed, by the patient for 6 to 10 times per hour. The machine is used for two post-operative days.
Oral Medications: The oral medications include Non-Steroidal Anti-Inflammatory drugs or NSAID; such as Celebrex which is similar to aspirin, structurally. Alternatively, acetaminophen, such as Tylenol or its equivalent composition, can also be used.
Acetaminophen: It acts on the Central Prostaglandin Synthesis and relieves the patient of pain through multiple mechanisms.
Epidural Analgesia: It produces lower pain scores and involves less time for achieving physical therapy goals. However, this is subject to side effects such as dizziness, urinary retention and itchiness.
The objective of multimodal treatments is to provide quick relief to the patient and immediately so. Earlier the rehabilitation, more successful will be the knee replacement surgery. In case you have a concern or query you can always consult an expert & get answers to your questions!