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Urinary Retention

Urinary retention is the inability to fully or partially empty the bladder. It ranges from chronic difficulty, where some urine always remains, to acute retention, where urination becomes suddenly and completely impossible. In ageing populations, it is a condition seen often in older men, though it can affect anyone.

Urecholine

Bethanechol

25mg

Bethanechol 25mg tablets, used in the management of urinary retention. A muscarinic agonist that mimics acetylcholine to contract the bladder.

From$1.36/ tabletView

Key points

  • In men the enlarged prostate typically squeezes the urethra shut, while in women pelvic prolapse or surgical scarring more often narrows the passage.
  • Diabetes, a spinal injury, or medicines including antihistamines and some antidepressants can all disrupt the nerve signals needed for the bladder to contract.
  • A sudden, total block on passing urine, together with a swollen and painful abdomen, requires urgent hospital treatment without delay.
  • When weak bladder-wall contraction, not a physical blockage, is the underlying issue, medicines such as bethanechol can stimulate the muscle to work harder.

Why the bladder stops emptying

The most common cause in men is an enlarged prostate pressing on the urethra. In women, pelvic organ prolapse or scar tissue from surgery can narrow the outlet. Nerve damage from diabetes, spinal injury, or certain medications (particularly antihistamines and some antidepressants) can also disrupt the signals that tell the bladder muscle to contract.

Relieving retention with medication

Where the cause is poor bladder muscle contraction rather than a blockage, medicines that stimulate the bladder wall directly can help. Bethanechol works this way, prompting the detrusor muscle to contract more forcefully. It is one of the options covered under bladder health at ZoneMD.

When to seek urgent care

Acute urinary retention, sudden inability to pass any urine, with a painful, distended abdomen, is a medical emergency. Go to a hospital without delay. Chronic retention with no pain can still cause kidney damage over time if left untreated, so persistent difficulty emptying warrants a medical assessment.

Further reading