Urinary Retention

1
Urinary Retention

• Signs and Symptoms
• Heather Nelson, RN

2
Urinary Retention

• Urinary retention is the accumulation of urine in
  the bladder with associated inability of the
  bladder to empty itself.
• Because urine production continues, retention
  distends the bladder.

3
Urinary Retention

• The adult urinary bladder normally holds 250 to
  450 ml of urine when the micturition reflex is
  triggered.
• With urinary retention, some adult bladders may
  distend to hold 3000 ml of urine.

4
Urinary Retention

• Prolonged retention leads to stasis (a slowing of
  the flow of urine) and stagnation of urine, which
  increase the possibility of a urinary tract
  infection.
• Distention causes reduced blood flow to the
  bladder, which is considered the major cause of
  urinary tract infections.

5
Clinical Signs of Urinary Retention

• Discomfort in the pubic area
• Bladder distention
• Inability to void or frequent voiding of small
  volumes (25 to 50 ml)
• A disproportionately small amount of fluid output
  in relation to intake
• Increasing restlessness and need to void

6
Bladder Distention

• Retention is distinguished from oliguria or
  anuria by the bladder distention.
• Bladder distention can be assessed by palpation
  and percussion above the symphysis pubis.
• Percussion of the suprapubic area produces a
  kettle-drum or dull sound when the bladder is
  full.

7
Urinary Retention

• The most common type of retention is
  post-operative retention.
• Postpartum retention is commonly due to swelling
  around the urinary meatus that results from
  perineal trauma associated with vaginal delivery.
• Many medications interfere with the normal
  urination process and may cause retention.
• Certain psychosocial factors may be associated
  with retention.

8
Urinary Retention

• Behaviors that may help stimulate the micturition
  reflex
• Privacy
• Normal position
• Sufficient time
• Running water