Rigi10™ Malleable Penile Prosthesis
Also Known As
Bladder retention, Incomplete bladder emptying, Urinary obstruction, Voiding dysfunction, Acute urinary retention (AUR), Chronic urinary retention (CUR), Post-void residual urine, Urinary stasis
Definition
Urinary retention is a condition in which an individual cannot empty all the urine from their bladder. It occurs when the bladder doesn’t completely empty during urination, resulting in residual urine remaining in the bladder.1 This condition can manifest in two primary forms: acute urinary retention, characterized by a sudden inability to urinate despite having a full bladder, often accompanied by lower abdominal pain and discomfort; and chronic urinary retention, which develops gradually over time with incomplete bladder emptying.2
The pathophysiology involves either a blockage that partially or fully prevents the flow of urine, or the bladder’s inability to maintain a strong enough contractile force to expel all the urine.3 Normal urination requires complex integration and coordination of neurological functions with pelvic sympathetic, parasympathetic, and somatic nerves to facilitate proper bladder storage and voiding.4 When this coordination is disrupted due to mechanical obstruction, neurological dysfunction, or medication effects, urinary retention can occur.
Clinical Context
Urinary retention is a significant urological condition that requires prompt evaluation and management, particularly in its acute form.1 The clinical presentation varies depending on whether the retention is acute or chronic. Acute urinary retention presents as a medical emergency characterized by the sudden inability to void despite a distended bladder, often accompanied by severe suprapubic pain, urgency, and discomfort.2 Chronic urinary retention typically presents with more subtle symptoms such as weak urinary stream, hesitancy, intermittency, frequency, nocturia, and a sensation of incomplete emptying.3
In men, benign prostatic hyperplasia (BPH) is the most common cause of urinary retention, with approximately 10% of men over age 70 and up to 30% of men over 80 developing this condition.4 In women, urinary retention is less common and often associated with neurological disorders, pelvic organ prolapse, or post-surgical complications.
Diagnostic evaluation includes a thorough medical history, physical examination, post-void residual urine measurement, urinalysis, renal function tests, and in some cases, urodynamic studies or cystoscopy.5 Management strategies depend on the underlying cause and may include catheterization for immediate relief, pharmacological interventions such as alpha-blockers or 5-alpha reductase inhibitors for BPH-related retention, or surgical interventions for obstructive causes.
Complications of untreated urinary retention include urinary tract infections, bladder damage from overdistension, hydronephrosis, and renal impairment.4 Therefore, early recognition and appropriate management are essential to prevent long-term sequelae.