This page has moved. Click here to view.


Urologic Emergencies

Acute Urinary Retention

Acute urinary retention is characterized by a sudden inability to void. It often presents with suprapubic pain and severe urgency. There is usually a history of preexisting obstructive voiding symptoms related to bladder outlet obstruction or poor detrusor function.

Complications of Acute Urinary Retention

Postobstructive diuresis

Urologic Emergencies Urologic Emergencies

Bladder mucosal hemorrhage



Renal failure

Autonomic bladder hyporeflexia

Benign prostatic hyperplasia is the most common cause of acute urinary retention in men over the age of 50.

Patients present with progressively worsening voiding difficulties,resulting in bladder overdistention and subsequent urinary retention. Prostate size on digital rectal examination has no bearing on the degree of outlet obstruction because minimal enlargement of the prostate can cause significant obstruction in some patients. Prostate cancer accounts for 25% of patients with acute urinary retention. 10% of patients with prostate cancer initially present with bladder outlet obstruction.

Additional Causes of Acute Urinary Retention: Urethral strictures, bladder neck contractures, bladder stones, and acute bacterial prostatitis.

Poor bladder function can cause acute urinary retention. Common causes of poor bladder urinary obstruction, nephrolithiasis, kidney stones function include prolonged obstruction, diabetes mellitus, neurologic disorders (spinal cord injury, herniated vertebral disk, dementia), and medications.

Urinary retention after surgery sometimes temporarily develops in elderly men. There is usually preexisting bladder dysfunction or outlet obstruction that predisposes the patient nephrolithiasis, kidney stones to urinary retention.

Anticholinergic medications (antihistamines, antidiarrheals, antispasmodics, tricyclic antidepressants) can suppress bladder function. Sympathomimetic drugs (decongestants and nephrolithiasis, kidney stones diet pills) that cause contraction of the smooth muscle in the bladder neck can precipitate an increase in outlet resistance.

Clinical urologic emergencies, urinary retention, urinary obstruction, nephrolithiasis, kidney stones Evaluation of Acute Urinary Retention

Retention is characterized by an inability to void and suprapubic discomfort. A progressive history of difficulty voiding and irritative voiding symptoms, such as frequency, nocturia, or urgency is