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).
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 infections, and other urinary tract issues.
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
c) medications: anticholinergics, narcotics
d) diabetes mellitus (autonomic neuropathy)
e) herpes zoster at the level of the sacral dorsal root ganglia