Urinary storage and voiding dysfunction refer to difficulty completely emptying the bladder while urinating.
Urinary Retention
Waste is filtered from the blood and stored in the kidneys as urine. Then, it moves to the bladder and through the urethra while urinating. Urinary retention can be acute (sudden) or chronic (long-term). Acute urinary retention comes on quickly and could be severe, while chronic urinary retention is a condition that lasts for an extended period of time.
Acute urinary retention is a medical emergency that requires immediate attention.
Symptoms of Urinary Retention
Individuals with chronic urinary retention may experience the following symptoms:
- Difficulty starting the flow of urine
- Weak flow of urine
- Inability to start urinating
- Need to continue urinating after done urinating
- Leaking urine because the bladder is full
Individuals with acute urinary retention may suddenly not be able to urinate at all, or only able to urinate in very small amounts. This can happen even if the individual has a full bladder.
Causes of Urinary Retention
Urinary retention may occur due to:
- A blockage in the urinary system
- Medications
- Problems with nerves interrupting communication between the brain and urinary system
- Infections and swelling preventing urination
- Complications and side effects of post-surgical medication
Diagnosing Chronic Urinary Retention
The physician will evaluate the patient’s symptoms, ask about their medical history, and examine the patient’s lower abdomen. Patients may need to undergo an ultrasound of the bladder, cystoscopy, urodynamic testing, electromyography (EMG), and a prostate-specific antigen (PSA) test.
Treatment Options for Urinary Retention
Depending on whether the patient has been diagnosed with chronic or acute urinary retention, they may be treated with medication, a prostatic urethral lift, water vapor therapy, surgery, pelvic floor muscle training, estrogen therapy, or a vaginal pessary.
Non-Neurogenic Voiding Dysfunction
Non-neurogenic voiding dysfunction is a condition that doesn’t have a neurologic cause. It’s typically associated with a blockage in the flow of urine, a weak bladder muscle, or habits that have formed over time.
Symptoms of Non-Neurogenic Voiding Dysfunction
Patients with this condition may experience the following symptoms:
- Difficulty starting urination
- Straining to urinate
- Slow or intermittent flow
- Needing to push with the stomach muscles or push on the lower abdomen with the hands to urinate
- Inability to fully empty the bladder
- Constipation
- Frequent urination
- Urinary incontinence
- Holding behavior, such as squatting or crossing the legs
- Urinating more than once at night
- Strong, sudden urge to urinate
Causes of Voiding Dysfunction
The condition may be caused by:
- Weak bladder muscles
- Blockage in the flow of urine
- Behavioral problems or habits that form over time
- Constipation
- Overactive bladder
- Dysfunctional elimination syndrome in children
- Urinary tract infection
- Ignoring the urge to urinate until the bladder is extremely full
- Underactive bladder that doesn’t trigger an urge to urinate
Diagnosing Non-Neurogenic Voiding Dysfunction
During a doctor’s appointment, the physician will review the patient’s medical history and perform a physical examination of the pelvis in women and the prostate in men. Testing may include urinalysis, PSA test, cystoscopy, ultrasound, and urodynamic testing.
Treatment Options
Non-neurogenic voiding dysfunction may be treated with bladder training, pelvic floor therapy, medication, bladder Botox injections, percutaneous tibial nerve stimulation (PTNS), sacral nerve stimulation, or self-catheterization.