Content

• Steps
• Advice

If you're having trouble emptying your bladder when you urinate, you may have urinary retention. The cause of this disease can be muscle weakness, nerve damage, kidney stones, bladder infection, enlarged prostate gland and other health problems. Urinary retention can be acute (short-term) and chronic (long-term) and presents with complete or partial loss of urine output in the bladder. In most cases, it can get better with some home remedies, but sometimes emergency intervention is also needed.

Steps

Part 1 of 2: Improve your ability to empty your bladder at home

1. 

   Increase pelvic muscle strength. One of the most popular and effective methods to strengthen pelvic floor muscles is to practice Kegel exercises. This is a simple exercise that you can do anywhere to strengthen the muscles that control your bladder, uterus, intestines, and rectum. To identify pelvic floor muscles, stop urinating halfway; The contractile muscles are the muscles that are exercised. Kegel exercises can be done in any position, so you can practice sitting in the car on the road, at the desk, etc.), although lying down is still easier.
   • Once you have identified your pelvic floor muscles, squeeze and hold for 5 seconds, then relax for 5 seconds. Repeat the process 5-10 times, several times a day for different times.
   • For a few weeks, try to keep your pelvic muscles tightening for 10 seconds at a time, then relax for 10 seconds. Do this exercise both standing and sitting, and repeat 5-10 times daily until bladder control improves.
   • Be careful not to confuse it with stretching your abs, thighs or buttocks, and remember to breathe comfortably during the exercise.
   • There are many factors that weaken the pelvic floor muscles, such as pregnancy, childbirth, surgery, aging, obesity, chronic cough, and excessive straining caused by constipation.

2. 

   
   
   Bladder exercises. Bladder exercise is an important behavioral therapy that helps treat urinary retention and incontinence. The aim of this therapy is to prolong the time between urination attempts, increase the amount of urine the bladder can hold, reduce the need to urinate and / or urinate. Bladder training requires you to empty your bladder at set times, regardless of whether or not you urinate. If you feel like urinating before your scheduled time, control it by contracting your pelvic muscles.
   • Try to empty your bladder as soon as you wake up, then pee every 1-2 hours, whether or not you feel upset.
   • When you can control your bladder and urinate as you like, extend the interval between peeings by 15–30 minutes until you are comfortable for 3-4 hours.
   • It usually takes 6-12 weeks for you to regain control of your bladder and empty your bladder every time you urinate.

3. 

   
   
   Create comfort in the toilet. The comfort of going to the bathroom can help you to normally empty your bladder. If the air temperature or the floor is too cold, you may be distracted from the task at hand. Sitting on the toilet seat can be the most comfortable position for both men and women, as many men experience back, neck or prostate pain when urinating. Privacy is also an important factor in comfort, so don't try to urinate at a public toilet and remember to close the bathroom door when you are at home.
   • Increase indoor temperature in winter. Remember to wear slippers and a gown when using the toilet to keep warm.
   • Place some scented candles in the bathroom and decorate the bathroom to look like a spa room to feel relaxed while you're trying to urinate.
   • If you are a “clean freak”, keep the bathroom in order so you don't get distracted or annoyed.
   • Take it easy. It takes an average of 30-60 seconds to urinate, so don't rush and be nervous.
   • Try turning on the water in the sink to stimulate the urge to urinate.

4. 

   
   
   External pressure or stimulation. Externally putting pressure on the bladder in the lower abdomen can stimulate urination and help the bladder drain all urine - consider it a kind of massage or physical therapy. Go online to learn about body composition to know the position of the bladder, then gently press (towards the spine) and downward (toward the feet) to try to "squeeze" the bladder during urination. This technique is easier to do while standing instead of sitting on the toilet and leaning forward.
   • Another way is to directly tap the skin / muscle / fat area of ​​the bladder to stimulate the bladder to contract and drain urine.
   • A woman can put a clean finger in the vagina and press it against the inner wall of the vagina to stimulate the bladder to empty.
   • For men, too much stimulation in the lower abdomen can make the penis erect and make it much harder to urinate. Therefore, you need to maintain the penis in a soft state when trying to empty your bladder.
   • Warm water running through your lower abdomen and genitals can also stimulate the urge to urinate. Therefore, try to urinate while standing in a warm shower.

5. 

   Learn how to insert a catheter yourself. If you really need to urinate and experience significant pain in your bladder and kidneys, a self-catheterization procedure may be the solution when none of the above tips are ineffective. This is the procedure of inserting a catheter (long, small tube) into the urethra close to the bladder opening to drain urine out. This procedure must be directed by your family doctor or a urologist, but not for people who are too careful or "shy".
   • Usually it is better to have a catheter inserted by your doctor after local anesthesia, but if you are confident and can use a lubricant in place of an anesthetic, try it.
   • Lubricants may reduce the need to take anesthetics, but some compounds (such as Vaseline cream) can irritate the mucous membranes of the urethra and cause pain.
   • It is important to thoroughly disinfect the catheter before it is inserted into the urethra, as any contact with bacteria can lead to infection.
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Part 2 of 2: Getting medical treatment

1. 

   Consult your doctor. If you have difficulty emptying your bladder for more than a few days in a row, you should make an appointment with your family doctor. The doctor will examine and try to find the cause of the problem. In addition to pelvic floor muscle weakness, other causes of urinary retention include urethral obstruction, bladder / kidney stones, genital tract infection, severe constipation, bladder prolapse (female), Prostate enlargement (male), spinal cord damage, antihistamine abuse and the effects of anesthetics after surgery.
   • Your doctor may take a urine sample, X-ray, computed tomography (CT scan), magnetic resonance imaging (MRI) and / or diagnostic ultrasound to determine the cause of your bladder problem. .
   • Obtain a referral to a urologist-genitalist for additional tests, such as a cystoscopy (placing a bronchoscope to look inside the bladder / urethra), urinary flow chart (measuring bladder ability to drain urine), and / or electromyography (measuring bladder / pelvic floor muscle activity).
   • Common symptoms of urinary retention include: lower abdominal pain, bloating, frequent need to urinate, difficulty starting / stopping urination, weak urine flow, and incontinence.
   • If you are extremely uncomfortable because your bladder is full and cannot urinate, your doctor may drain the bladder with a catheter - a relatively quick outpatient procedure performed with a local anesthetic. You may be instructed to have a catheter at home (see above).

2. 

   Ask about medications. Ask your doctor if your bladder problem and inability to empty your urine can be treated with medicine. Some drugs can relax and widen the smooth muscles of the urethra and bladder opening, although long-term use can have the opposite effect - incontinence and loss of bladder control. For men with an enlarged prostate gland (a common cause of bladder / urinary problems), medications such as dutasteride (Avodart) and finasteride (Proscar) work to prevent the increase. Prostate benign birth, even help shrink the prostate gland.
   • Medicines that relax the bladder / urethra muscles and treat prostate enlargement include: alfuzosin (Uroxatral), doxazosin (Cardura), silodosin (Rapaflo), tadalafil (Cialis), tamsulosin (Flomax) ), terazosin (Hytrin).
   • Medications are considered as a short-term solution only and not a long-term treatment for urinary retention.

3. 

   Consider urethral dilatation and urethral stenting. Urethra dilatation helps to clear the urethra by inserting tubes with increasing radius into the urethra and dilating the urethra. The stenting procedure is also used to dilate the narrowed urethra, but the stent tube can expand like a spring and gradually push back the surrounding tissue instead of being replaced by larger tubes. The stent tubes can be placed either temporarily or permanently. Urethritis and stenting are both outpatient procedures and require local anesthesia, sometimes requiring anesthesia.
   • Another method of expanding the urethra is to inflate a small balloon attached to the end of the catheter.
   • These procedures are performed by a specialist in urology and genitalia.
   • Unlike normal catheterization, urethral dilatation and stenting are not done at home under any circumstances.

4. 

   Consider sacramental nerve conditioning. Neuromodulation, also known as InterStim therapy, is a technique that uses mild electrical impulses to act on the nerves that control the bladder and pelvic floor muscles involved in urination. This therapy helps the brain, nerves and smooth muscles work better, so that the bladder can drain urine properly and regularly. The device is surgically inserted into the body and turned on, but this is a method that can be reversed and stopped at any time by turning the device off or off from the body.
   • This therapy is also known as sacral nerve stimulation, although the nerves inside and around the sacrum can also be stimulated manually with a vibrating massage device. You can try this at home and see if your condition improves.
   • Sacral nerve stimulation therapy is not indicated for obstructive urinary retention.
   • Note that not all forms of non-obstructive urinary retention can be treated with sacral nerve stimulation therapy, so you should check with your urologist if this therapy is right for you. are not.

5. 

   Consider surgery as a last resort. When none of the above techniques and treatments help to improve your bladder / urination problem, surgery will be considered a last resort if your doctor thinks this might be helpful. There are many types of surgeries, but which one depends on the real cause of the problem. Some types of surgeries to correct urinary retention include: laparoscopic urethral opening procedure, surgery for bladder prolapse or colostomy in women, and prostate surgery in men.
   • A laparoscopic urethral opening is a procedure that clears the ureter by placing a special catheter with a laser at the tip of the tube.
   • Surgery to prolapse or rectal prolapse involves removing cysts, repairing holes, strengthening the vagina and surrounding tissues to bring the bladder to its normal position.
   • To treat urinary retention due to benign prostatic proliferation, part or all of the prostate gland is removed, usually by urethral fallectomy (using a catheter inserted through the urethra).
   • Other types of surgery may be performed to remove tumors and / or cancerous tissues in the bladder or urethra, if appropriate.
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Advice

• The sound of running water stimulates the nervous system rather than the physical stimulus. It works for most people, but usually works better for men.
• Avoid caffeine and alcohol. These substances increase the need to urinate but often cause additional bladder irritation.
• Whistling while pee. Whistling helps you press on your bladder with light pressure.
• Urinary retention is more common in men, and the rate increases with age. The incidence of urinary retention in men aged 40-83 is 0.6%.
• Urine flowing back from the bladder into the kidneys can lead to permanent damage and impaired function.