What Are The Symptoms Of Urinary Retention
The signs can vary. Some people with the chronic form have a hard time starting the flow of urine. Some have a weak flow once they start. Others may feel the need to go but cant start. Others have to go a lot, while others still feel the need to go right after going. You may leak urine when you arent going because the bladder is full.
With the acute form, youre all of a sudden not able to go at all, or only able to go very small amounts. This occurs even though you have a full bladder. See a healthcare provider right away if this happens to you.
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. When urine stays in the bladder, however, bacteria have a chance to grow and infect the urinary tract.
Bladder Damage
If the bladder becomes stretched too far or for long periods, the muscle may be permanently damaged and lose its ability to contract.
Chronic Kidney Disease
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.
What Medications Treat Bladder Control Problems
Anticholinergic and spasm-relieving drugs are used in urge incontinence to suppress bladder contraction and relax bladder smooth muscle. This class of drugs includes darifenacin , dicyclomine , flavoxate , hyoscyamine , methantheline , oxybutynin , solifenacin , tolterodine , and trospium . Anticholinergic agents may help relieve urge incontinence.
Myrbetriq is a beta-3 adrenergic agonist indicated for the treatment of overactive bladder with symptoms of urge urinary incontinence, urgency, and urinary frequency.
Some tricyclic antidepressants , such as imipramine , have strong anticholinergic effects and may be prescribed to treat incontinence. Because the effects of newer, long-acting agents last throughout the day, they need to be taken only once daily, which makes them very convenient. Additionally, the effects of Detrol and Detrol LA are mostly limited to the bladder, thus lessening the prevalence of side effects typically caused by anticholinergic medications.
Medications are sometimes used in stress incontinence. These medications can have serious side effects, such as high blood pressure. They are not for everyone. These medications include adrenergic agonists, such as midodrine and pseudoephedrine , which increase internal sphincter tone.
No medications are effective in treating overflow incontinence. A drug called Urecholine has been FDA approved for overflow incontinence but has not met with a lot of success in clinical practice.
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What Is The Urinary Tract
The urinary tract consists of the organs, tubes, and muscles that work together to make, move, store, and release urine. The upper urinary tract includes the kidneys, which filter wastes and extra fluid from the blood, and the ureters, which carry urine from the kidneys to the bladder. The lower urinary tract includes the bladder, a balloon-shaped muscle that stores urine, and the urethra, a tube that carries urine from the bladder to the outside of the body during urination. If the urinary system is healthy, the bladder can hold up to 16 ounces2 cupsof urine comfortably for 2 to 5 hours.
Muscles called sphincters squeeze shut the tubes from the bladder to help keep urine from leaking. The sphincter muscles close tightly like a rubber band around the opening of the bladder, which leads into the urethra.
Nerves in the bladder tell you when it is time to urinate. As the bladder first fills with urine, you may notice a feeling that you need to go. The sensation to urinate becomes stronger as the bladder continues to fill. As it reaches its limit, nerves from the bladder send a message to the brain that the bladder is full and the urge to empty your bladder intensifies.
Is There Surgery For Bladder Control Problems
Surgery for urinary incontinence either corrects an anatomical problem or implants a device to alter bladder muscle function.
- Most people do not need surgery, but most of those who have surgery become dry.
- Like any surgery, these procedures do not work on everyone. A small number of people are not completely dry after surgery.
- Like all surgery, these operations can have complications.
- Each of these procedures is appropriate only for a certain type or types of incontinence.
- A urogynecologist or urologist can advise you about which, if any, might work for you.
Types of operations used in people with incontinence include the following:
- Altering the position of the bladder neck, which can change how urine is released from the bladder
- Repairing or supporting severely weakened pelvic floor muscles
- Removal of a blockage
- Implantation of a “sling” around the urethra
- Implantation of a device that stimulates the nerves to increase awareness of the need to urinate
- Injection of a naturally occurring material called collagen around the urethra
- Injection of Botox into the bladder muscle using a cystoscope
- Surgical placement of an artificial urinary sphincter
- Enlargement of the bladder
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When To See A Doctor
People with warning signs should go to an emergency department at once. People without warning signs should call their doctor. The doctor will decide how quickly they need to be seen based on their other symptoms and other known conditions. In general, if incontinence is the only symptom, a delay of a week or so is not harmful.
Most people are embarrassed to mention incontinence to their doctors. Some people believe that incontinence is a normal part of aging. However, incontinence, even incontinence that has been present for some time or that occurs in an older person, may be helped by treatment. If symptoms of urinary incontinence are bothersome, interfere with activities of daily living, or cause people to curtail their social activities, people should see a doctor.
What Causes Chronic Urinary Retention
Urinary retention can happen for several different reasons. These causes can include:
- A blockage to the way urine leaves your body.
- Medications youre taking for other conditions.
- Nerve issues that interrupt the way your brain and urinary system communicate.
- Infections and swelling that prevent urine from leaving your body.
- Complications and side effects of medications given to you for a surgical procedure.
Blockage
When something blocks the free flow of urine through the bladder and urethra, you might experience urinary retention. The urethra is the tube that carries urine from the bladder to the outside of your body. In men, a blockage can be caused when the prostate gland gets so big that it presses on the urethra. This is the most common cause of chronic urinary retention in men. One cause in women is a bladder that sags. This is called cystocele. It can also be caused when the rectum sags into the back wall of the vagina a condition called rectocele. Some causes can happen to both men and women. The urethra can get narrow due to scar tissue. This is called a stricture. Urinary stones can also block the flow of urine out of your body.
Medications
Nerve issues
- Trauma to the spine or pelvis.
- Pressure on the spinal cord from tumors and a herniated disk.
- Vaginal childbirth.
Urinary retention from nerve disease occurs at the same rate in men and women.
Infections and swelling
Surgery
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Treatment Of Urinary Incontinence
Treatment usually begins with bladder training and Kegel exercises. Avoiding physical stresses that cause loss of urine and losing weight may help control incontinence. Pseudoephedrine may be useful in women with bladder outlet incompetence. Imipramine may be used for mixed stress and urge incontinence Urge incontinence Urinary incontinence is involuntary loss of urine. Incontinence can occur in both men and women at any age, but it is more common among women and older people, affecting about 30% of older women… read more or for either separately. Duloxetine is also used for stress incontinence. If stress incontinence is caused by atrophic urethritis or vaginitis, estrogen cream is often effective. For people with stress incontinence, urinating frequently to avoid a full bladder is often helpful.
For stress incontinence that is not relieved with drugs and behavioral measures, surgery or devices such as pessaries may be helpful. The vaginal sling procedure creates a hammock of support to help prevent the urethra from opening during coughing, sneezing, or laughing. Most commonly, a sling is created from synthetic mesh. Mesh implants are effective, but a few people with mesh implants have serious complications. Alternatively, doctors can create a sling using tissue from the abdominal wall or leg. In men with stress incontinence, a mesh sling or an artificial urinary sphincter implant may be placed around the urethra to prevent leakage of urine.
Causes Of Urge Incontinence
The urgent and frequent need to pass urine can be caused by a problem with the detrusor muscles in the walls of your bladder.
The detrusor muscles relax to allow the bladder to fill with urine, then contract when you go to the toilet to let the urine out.
Sometimes the detrusor muscles contract too often, creating an urgent need to go to the toilet. This is known as having an overactive bladder.
The reason your detrusor muscles contract too often may not be clear, but possible causes include:
- drinking too much alcohol or caffeine
- not drinking enough fluids this can cause strong, concentrated urine to collect in your bladder, which can irritate the bladder and cause symptoms of overactivity
Overflow incontinence may also be caused by your detrusor muscles not fully contracting, which means your bladder does not completely empty when you urinate. As a result, the bladder becomes stretched.
Your detrusor muscles may not fully contract if:
- there’s damage to your nerves for example, as a result of surgery to part of your bowel or a spinal cord injury
- you’re taking certain medicines
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Causes And Treatments For A Dogs Weak Bladder
Causes
1) Your beloved pet is consuming more water than is normal. This often leads to a weak bladder and the need to urinate often. This is often a sign the dog may have medical issues such as diabetes, kidney failure, or hyperthyroidism.
2) If the dog has had recent urinary tract infections, this can cause the bladder to weaken. This may be a temporary problem once the infection is cured, especially in younger dogs.
3) In female dogs a decrease in hormones such as estrogen can result in a weak bladder sphincter causing the dog to urinate more than normal.
4) If your dog has suffered an injury or been diagnosed with a disease to the spinal cord this is possibly the cause. Also any injury to the lumbar area is another possible cause for the incontinence.
Treatments
1) If you suspect your dog might be suffering from one of these problems, there is a relatively easy procedure your local vet can perform as a way to pin down what the cause is. Have your vet do a urinalysis or urine culture at their office. In most cases this will be all that is needed to diagnose the problem properly. If this does not yield the results for correcting the problem, the vet can then do a radiograph and blood panel test to further narrow down the issue of why your dog in fact has a weak bladder.
3) There are several drugs that can be given if there is no specific cause found. According to an article on the Medi-Vet.com website:
Bladder Weakness Causes And Treatments
Bladder weakness or urinary incontinence affects around 50 million people in the developed world at some point or other . In fact, according to the NHS, between three and six million people in this country have some degree of incontinence problems.Bladder problems can affect men, women, the young and the old. As many as one in five women aged 40 or older is thought to have urinary incontinence to some extent or other , with studies suggesting that between three and 11 per cent of men are affected too . Yet while it can happen at any age, youre more likely to develop urinary incontinence as you get older . The good news, however, is that while many people think incontinence is an inevitable part of ageing, experts believe that in about 80 per cent of cases it can be cured or improved .Two most common types of urinary incontinence are called stress incontinence and urge incontinence:
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Medication Triggers Of Urinary Incontinence
Check the Medicine Cabinet
Certain medications may trigger urinary incontinence or make it worse. Drugs that affect the brain, nervous system, muscle tone, and fluid balance may trigger the problem. Never stop taking a prescription or change the dose without speaking with your health professional. If you have concerns that a medicine you’re taking may be contributing to your symptoms, discuss the issue with your physician. It may be possible to substitute a problematic drug with another drug that does not cause side effects.
Some Medications Worsen The Problem
Certain classes of medicine increase the risk of incontinence symptoms. Blood pressure medications may relax the bladder, increase coughing, or decrease the tone of the urethral sphincter, all of which may contribute to this health concern. Pain relievers may increase fluid retention or relax or inhibit contraction of the bladder. Drugs to treat depression, Parkinson’s disease, or psychosis may increase the retention of urine. When you really need to urinate badly, some of that urine may leak. Antihistamines and anticholinergic drugs may have similar effects.
What Causes Bladder Control Problems
Incontinence is a symptom with a wide variety of causes. The most common causes include the following:
- Urinary tract infection
- Side effect of medication: Examples include alpha-blockers, calcium channel blockers, antidepressants, antihistamines, sedatives, sleeping pills, narcotics, caffeine-containing preparations, and water pills . Occasionally, the medicines used to treat some forms of incontinence can also worsen the incontinence if not prescribed correctly.
- Impacted stool: Stool becomes so tightly packed in the lower intestine and rectum that a bowel movement becomes very difficult or impossible.
- Weakness of muscles in the bladder and surrounding area: This can have a variety of causes.
- Blocked urethra, usually due to enlarged prostate
- Prior prostate, bladder, or pelvic surgery
- Nerve damage or neurological diseases
Many of the causes are temporary, such as urinary tract infection. The incontinence improves or goes away completely when the underlying condition is treated. Others are longer lasting, but the incontinence can usually be treated.
Risk factors: Underlying causes or contributors to urinary incontinence include the following:
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Treatment For Stress Urinary Incontinence
It is important to have your symptoms assessed by a health professional who will assess your bladder behaviour and pelvic floor and confirm that you have stress urinary incontinence.
The main treatment for stress incontinence is pelvic floor exercises. Surgery to tighten or support the bladder outlet can also help. Medication may be used in addition to exercises if you do not want, or are not suitable for surgery.
There is medication available for treating women with moderate to severe stress urinary incontinence, along with pelvic floor muscle exercises. Older people with other problems in addition to their bladder may benefit from seeing a specialist in medicine for older people.
What Are The Symptoms Of Overactive Bladder Syndrome
The symptoms of OAB syndrome include:
- Urgency:
- This means that you have a sudden urgent desire to pass urine. You are not able to put off going to the toilet.
- Latch key urgency is the name given to the urgent need you might feel to pass urine as soon as you get home and put your key in the door.
- Frequency:
- This means going to the toilet more often than normal – usually more than eight times a day. In many cases it is a lot more than eight times a day.
- Nocturia:
You can read more about other urinary symptoms and their causes in the two separate leaflets called Lower Urinary Tract Symptoms in Men and Lower Urinary Tract Symptoms in Women .
Filling out a bladder diary will help your doctor work out which treatments would be best for you. Ideally, this should include details of your symptoms, what you ate and drank and your activities. It is best to complete the diary for at least three days and cover variations in your usual activities, such as both working and leisure days.
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Bladder Training For Urinary Incontinence
Stick to a Schedule
Bladder training is a useful way to treat both common forms of urinary incontinence. To implement this training, go to the bathroom at set times to urinate. The goal is to urinate frequently enough that it minimizes urges to void and accidents. As the bladder strengthens and accidents are less frequent, you can increase the length of time between bathroom trips. Stick to the schedule whether or not you feel the need to urinate. If your goal is visit the restroom every hour and 15 minutes, do so to help decrease your symptoms.
Length of Training
Training may take between 3 and 12 weeks or longer. During the program, the physician may ask you to keep a diary of your bathroom habits including when and how much you urinate. You may be asked to record your fluid intake and if and when you have any accidents and how much you lose at a time. This information will help you and your health professional identify triggers for your symptoms and help optimize treatment.