Urinary Retention - Treatment - Complications

Complications

The acute urinary retention is treated by placement of a urinary catheter (small thin flexible tube) into the bladder. This can be either an intermittent catheter or a Foley catheter that is emplaced with a small inflatable bulb that holds the catheter in place.

Intermittent catheterization can be done by a health care professional (nurse/ doctor) or by the patient himself /herself (clean intermittent self catheterization). Intermittent catheterization performed at the hospital will be a sterile technique done by nurses /doctores, while patients can be taught to use a self catheterization technique in one simple demonstration, and that reduces the rate of infection from longer term Foley catheters. Self catheterization requires doing the procedure every 3 or 4 hours 4-6 times a day. The chronic form of urinary retention may require some type of surgical procedure. While both procedures are relatively safe, complications can occur.

In acute urinary retention, the treatment requires urgent placement of a urinary catheter (tube) into the urethra and into the bladder. These catheters are usually inserted by health care professionals. However, if the procedure is not accomplished in a sterile fashion, it can introduce bacteria into the bladder. This can result in an infection of the entire urinary tract. Therefore, sterile technique is a must when inserting a foley catheter. Careful washing of hands, meatus, and reusable catheters are also necessary with clean self catheterization techniques.

Sometimes the permanent urinary catheter may cause discomfort and pain which often lasts for several days. The urinary catheter must be placed into the bladder and not near the prostate gland. Placement of the catheter near the prostate can lead to bleeding and significant irritation. In most patients with benign prostate hyperplasia (BPH), a procedure known as transurethral resection of the prostate (TURP) is performed to relieve bladder obstruction. The surgery is done with a small lighted instrument which is inserted into the urethra under anesthesia. The surgeon can core out the enlarged prostate and relieve obstruction. However, the procedure does have risks. There are risks of anesthesia which may include allergy to medications or low blood pressure which results from spinal anesthesia.

The surgical complications from TURP include a bladder infection, bleeding from the prostate, scar formation, inability to hold urine and inability to have an erection. The majority of these complications are short lived and most individuals recover fully within 6–12 months. Some people with BPH are treated with medications like finasteride or dutasteride to decrease prostate enlargement. The drugs only work for mild cases of BPH but also have mild side effects. Some of the medications decrease libido and may cause dizziness, fatigue and lightheadedness. Unfortunately, medications only work in less than 5 percent of individuals with BPH.