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  • Incomplete Bladder Emptying

    Incomplete bladder emptying, or Urinary retention, is the abnormal holding of urine in the bladder.

    Normally, urination can be initiated voluntarily and the bladder empties completely.

    The area of the spinal cord which controls the emptying reflex, when it becomes damaged, results in a weak bladder muscle and as a result the bladder muscle stops contracting before the bladder is empty. To put it another way, if the bladder muscle is weak or does not contract as it should, then the bladder will not empty properly. For these people while urine may be easy to pass and may flow normally, the bladder does not empty properly (this is known as retention). 

    Acute urinary retention is the sudden inability to urinate, causing pain and discomfort. Causes can include an obstruction in the urinary system, stress, or neurologic problems. Chronic urinary retention refers to the persistent presence of urine left in the bladder after incomplete emptying. Common causes of chronic urinary retention are bladder muscle failure, nerve damage, or obstructions in the urinary tract. Treatment for urinary retention depends on the cause.

    Illustration of the urinary tract

     

    Incomplete bladder emptying can be caused by an inadequately contractile bladder, urethral sphincter obstruction, or both.

    Incomplete bladder emptying resulting from urethral obstruction is most commonly caused in men by benign prostatic hyperplasia,

    In the nonobstructive form of impaired bladder emptying there is no problem with the urethra but the bladder muscle is less able to adequately contract. When the bladder cannot contract properly, some or all of the urine remains in the bladder. 

    The condition of incomplete bladder emptying is becoming more common with the aging of the population and the widespread use of anticholinergic drugs to treat overactive bladder.

    Incomplete bladder emptying can often lead to overflow incontinence, and if left untreated, this condition can lead to urinary tract infection and damage to the kidneys. When the bladder is unable to empty, the pressure inside it will eventually build up so much that urine leaks ‘off the top’. This is known as overflow incontinence and is non-acute retention. There may be an almost continuous leakage of urine (dribble incontinence).

    This sort of problem is mostly seen in men with prostate problems but can occur in women, particularly if there is pressure on the bladder from a large uterine fibroid. Overflow incontinence can also occur in association with other medical problems such as multiple sclerosis where bladder coordination is lost. In these cases, the bladder contracts to empty but at the same time the urethral sphincter (the ring of muscles controlling the opening of the bladder) contracts to stop the bladder emptying.

     

    If you believe you have bladder problem, then you should see a Family Practice, Internal Medicine, Gynecology or Urology specialist.

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