Q: What does a man do if he is unable to urinate?
A: Some individuals may find temporary relief by sitting in a tub of warm water or by simply turning on a water faucet in a sink that can often stimulate a urinary flow. Other than that, there is little that can be accomplished at home since a true inability to urinate requires prompt medical attention.
The most common cause for urinary retention is because of a narrowing or stricture within the urethra, the small tubular structure that drains urine from the bladder. The bladder is an organ similar to a balloon in the pelvis that stores urine. When the condition occurs in men, it is often because of an enlarged prostate – also a common condition. This is because as a man ages, the prostate that partially surrounds the urethra causes pressure and blockage. There are also several other medical issues that can result in urinary retention. The first is an after effect of surgery that may be related to the type of operation performed, scar tissue, or even resulting from the anesthetic used. Infection or a growth around the spinal cord can cause retention, simply by the pressure placed on the spinal cord nerves that supply the bladder. Extended periods of immobility such as bed rest occurring after a fall might even be to blame. Then there is medication. Specific drugs can cause urinary retention – especially in those men who suffer from prostate enlargement. Over-the-counter cold and allergy relief drugs can also be responsible for retention.
Urine is composed of water and waste filtered from the blood by the kidneys that travels through two tubes known as ureters from the kidneys to the bladder. In a healthy individual, when 200 to 300 ml of urine (about a cup) collects in the bladder, a signal passes to the nerves in the brain and spinal cord. The brain in turn returns the signal to the muscles of the bladder to contract and the surrounding muscles to relax allowing urine to flow from the bladder. If you or the individual you are writing about were to go to hospital, the likely procedure taken would be insertion of a Foley catheter through the urethra and into the bladder. Upon insertion, the urine should flow into a bag. When an obstruction occurs there are other procedures that can be put into practice with one possibility being a catheter placed through the skin in the area of the pubic bone, through the lower abdominal wall, and directly into the bladder.
For those individuals with chronic urinary retention, implantable devices are now available that function by stimulating the nerves that control the bladder. When the bladder is allowed to relax and contract, urination should occur. This condition is rather common and is diagnosed more frequently in men than it is in women.
Individuals – male or female – with urinary retention should be seen by a urologist to determine the base cause of the problem. For this I recommend a urologist be consulted. He or she can determine from the history provided, examination performed, and perhaps minimal testing, how serious the condition really is. Don’t wait. Get the ball rolling (and the urine flowing) now.
Other readers who would like related information can order Dr. Gott’s Health Reports “Bladder and Urinary Tract Infections and “The Prostate Gland” by sending a stamped number 10 envelope and a $2 (for each report) US check or money order to Peter H. Gott, MD Health Report, PO Box 433, Lakeville, CT 06039. Be sure to mention the title(s) or print an order form from www.AskDrGottMD.com.
