Urinary retention [Neurosurgery Wiki]

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====== Urinary retention ======

Urinary retention, also known as ischuria, is an inability to completely empty the bladder. It is a common complication of benign prostatic hyperplasia (BPH).

[[Cauda equina syndrome]] usually produces [[urinary retention]], although sometimes [[urinary incontinence]] may occur (some cases are overflow incontinence).
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Elevated [[Postvoid residual volume]] can be indicative of several conditions, including [[urinary retention]], [[neurogenic bladder]] dysfunction, bladder outlet obstruction (such as in benign prostatic hyperplasia in men), [[urinary tract infection]]s, and other urinary tract issues.


===== Etiology =====
Etiologies of urinary retention:

1. bladder outlet obstruction (a brief differential diagnosis list is presented here)

a) urethral stricture:retention tends to be progressive over time

b) prostatic enlargement in males:

● benign prostatic hypertrophy (BPH) & prostate cancer: retention tends to be progressive over time

● acute prostatitis: onset of retention may be sudden

c) women: bladder or vaginal prolapse which can produce a urethral kink

d) obstructing thrombus from hematuria(clot retention)

e) bladder calculi

f) bladder or urethral foreign bodies

g) urethral cancer:rare

2. detrusor areflexia or hypotonia

a) spinal cord lesion

● trauma

● tumor

● myelomeningocele

b) [[cauda equina syndrome]]

c) medications: anticholinergics, narcotics

d) diabetes mellitus (autonomic neuropathy)

e) herpes zoster at the level of the sacral dorsal root ganglia

3. [[Postoperative urinary retention]]