Urinary retention refers to the inability to completely empty the bladder. It is a common condition that can affect anyone, but is more frequent in older adults. Urinary retention causes urine to remain in the bladder after voiding, which can lead to complications if left untreated. But how long is too long to be in urinary retention?
What is urinary retention?
Urinary retention, also called ischuria, is the inability to completely empty the bladder. With urinary retention, some amount of urine remains in the bladder after voiding. This is different from normal urination where the bladder empties completely.
There are two main types of urinary retention:
- Acute urinary retention – when you suddenly cannot urinate at all
- Chronic urinary retention – when you have persistent difficulty fully emptying the bladder over time
Some common symptoms of urinary retention include:
- Difficulty starting a urine stream
- Weak urine stream
- Dribbling of urine
- Pain or pressure in the bladder
- Abdominal discomfort
- Frequent urination
- Sudden inability to urinate at all (acute retention)
What causes urinary retention?
There are several possible causes of urinary retention:
- Nerve problems – Damage to the nerves that control bladder function, such as from diabetes, stroke, MS, Parkinson’s disease
- Bladder problems – Bladder muscle damage, bladder stones, tumors or polyps in the bladder
- Prostate issues – Enlarged prostate or prostate inflammation in men
- Urethral stricture – Scar tissue narrowing the urethra
- Medications – Cold medicines, antidepressants, narcotics, antihistamines
- Pregnancy – Pressure from the uterus on the bladder
- Surgery – Side effect of anesthesia, trauma during surgery
In many cases, the exact cause of urinary retention is unknown.
How is urinary retention diagnosed?
Urinary retention is typically diagnosed through a medical history, physical exam, and tests such as:
- Post-void residual urine test – Measures urine left in bladder after voiding
- Urinalysis – Checks for infection, blood, or other abnormalities
- Ultrasound – Evaluates bladder size and shape
- Cystoscopy – Camera to view inside the urethra and bladder
- Urodynamic testing – Assesses bladder function
Based on the results, your doctor can determine if urinary retention is present and try to determine the underlying cause.
How long can you safely be in urinary retention?
There is no definitive “safe” period to be in urinary retention. In general, urinary retention should be treated promptly to avoid potential complications.
With acute urinary retention, when you suddenly cannot urinate at all, emergency treatment is needed. Seeking medical care within 6-24 hours is recommended, as the bladder can be permanently damaged if strained and overfilled for too long.
For chronic urinary retention, where you have persistent difficulty fully voiding over time, the risks increase the longer retention goes unchecked. Exactly how long it takes to cause harm can vary by individual.
Some general guidelines on chronic urinary retention duration:
- Seeking treatment within 1-2 weeks is ideal
- Being in chronic retention for over 2-4 weeks risks bladder damage
- Being in chronic retention for months at a time often causes permanent bladder dysfunction
However, these timeframes are not precise, and damage can certainly occur earlier. Any difficulty fully emptying the bladder regularly should be evaluated right away.
What problems can prolonged urinary retention cause?
Allowing urinary retention to go unchecked can lead to several complications, including:
- Bladder distension – Overstretching and damage to the bladder muscle
- Urinary tract infections – Bacteria multiplying in trapped urine
- Bladder stones – Mineral deposits forming stones in the bladder
- Kidney damage – Backflow and kidney function impairment over time
- Incontinence – Loss of bladder control
- Bladder rupture – Tearing of the overfull bladder
If urinary retention causes obstruction of the ureters between the kidneys and bladder, kidney failure can rapidly develop.
How is urinary retention treated?
Treatment options for urinary retention include:
- Catheterization – Insertion of a thin tube to drain urine from the bladder
- Medications – Alpha blockers or antimuscarinics to improve bladder emptying
- Surgery – Removal of obstructions, implants to stimulate bladder emptying
- Lifestyle changes – Treatment of underlying causes, pelvic floor therapy, double voiding
Treatment focuses on draining the backed-up urine from the bladder and managing any underlying causes to try preventing recurrence of retention.
Prompt treatment is key to restoring normal urination and avoiding lasting bladder dysfunction or damage to the kidneys.
When should you seek emergency care for urinary retention?
You should seek emergency medical care right away if you experience:
- Inability to urinate at all
- Severe pain or pressure in the bladder
- Visible or palpable distension of the lower abdomen
- Fever due to possible kidney infection
- Bleeding from the urethra
- Profuse sweating, confusion, chest pain, shortness of breath
Rapid care is needed to drain the urine from your bladder, manage any infection, and prevent life-threatening complications from bladder rupture or kidney damage.
Can you permanently damage your bladder from retention?
Yes, it is possible to cause permanent bladder damage if urinary retention goes untreated for too long. Exactly how long is “too long” varies by individual.
But in general, the bladder muscle can become overstretched and lose effectiveness if strained from urine retention over time. This is known as bladder decompensation.
Signs that urinary retention has caused permanent bladder damage include:
- Inability to fully empty the bladder even after treatment
- Greatly reduced bladder capacity
- Frequent or uncontrolled leakage of urine
- Recurring bladder infections
- Kidney dysfunction from backflow of urine
These complications can become irreversible if retention is left for too long before treatment. That is why prompt medical care for urinary retention is crucial.
How can urinary retention be prevented?
Steps to help prevent urinary retention include:
- Get treated early for prostate enlargement in men
- Maintain good control of diabetes to protect nerves
- Do Kegel exercises to strengthen pelvic floor muscles
- Avoid bladder irritants like caffeine and alcohol
- Stay well hydrated to avoid concentrated urine
- Use the bathroom regularly and avoid waiting if feeling urgency
- Treat chronic constipation to avoid straining
- Carefully monitor medication side effects
Seeking prompt care for any urinary difficulties can help prevent acute retention episodes or worsening chronic retention.
Key Points
- Urinary retention means the bladder does not empty fully and some urine remains after voiding.
- Acute urinary retention is a sudden inability to urinate at all and is a medical emergency requiring prompt treatment.
- Chronic urinary retention causes persistent incomplete bladder emptying and progressively worse symptoms over time.
- Urinary retention lasting more than 2-4 weeks risks permanent bladder dysfunction or damage.
- Untreated retention can lead to numerous complications like infections, stones, incontinence, and kidney impairment.
- Prompt drainage, treatment of underlying causes, and bladder retraining are key to managing retention.
In summary, urinary retention that persists more than a few weeks can often cause lasting bladder problems. Seeking medical advice as soon as retention symptoms arise is crucial to preserve normal bladder and kidney function.
Conclusion
Urinary retention should never be ignored, as the risks and potential complications rise significantly the longer it goes untreated. While an exact “safe” duration of retention is hard to define, it is best to seek medical care within 1-2 weeks at most. Acute retention is a medical emergency requiring immediate treatment. If urinary retention is addressed early, the likelihood of reversing it and preventing permanent bladder damage is much higher. Don’t wait if you suspect a problem fully emptying your bladder.
