Urinary retention

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Can anyone tell me what causes urinary retention or leads up to it? I'm hoping it isn't a normal progression of urinary incontinence. Is there anything I can do to prevent it from happening? I never just allow my bladder to empty into my diaper- when I am losing urine, I am still trying my best to hold it in. The only time I release control is when I am using a toilet - at home or work. Am I contributing to future problems?

 

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As I understand it, the medical term "urinary retention" refers to not being able to empty your bladder completely even when you try to do so. What you're doing thus doesn't fit the medical definition of urinary retention because you can fully empty your bladder when you try to do so in a toilet.

Your description of your incontinence makes it sound as if it's what's called "urge incontinence." You get strong feelings that you need to urinate and start leaking urine if you don't get to the toilet fast enough. I have had the same condition for most of my life. For me at least, trying to stop the flow once I've begun to leak uncontrollably is painful; and the more I try to stop the leaking the more it hurts. So when the situation arises, I just allow my bladder to empty into my diaper. In my opinion, that's what a diaper is for.

My strategy to reduce the frequency of involuntary urine loss is to use the bathroom at least once every couple of hour during the day. In other words, I try not to let my bladder fill to the point where an uncontrollable "urge" occurs.

 

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I actually have urge incontinence and retention. They treated me for years for urge incontinence without success. When they finally did a full urological evaluation my problem is I went years delaying trips to the bathroom because of work conditions. Sometimes I would go 12-16 hours without a trip. Toward the end of those long hours I would feel a lot of pressure but no sudden urges or urine losses. I managed (without realizing it)to "stretch" out my bladder. So when my incontinence did start, I was pretty confused but the conclusion of the work up is that I retain my urine without sensation until my bladder fills. During testing the sensation doesn't start until I have 1200 mls in my bladder. The sensation is an over powering urge I can't control and lose an entire liter of urine in my pants which explains why I only void 2-3 times a day weather voluntarily or not. But if you are suffering from incontinence, you won't "develop" a retention problem unless it already exists. The only thing you are doing by trying to "hold" even when you are leaking is delaying the inevitable and suffering with a bunch of frustration. You don't mention what the cause of your incontinence is, but if it is urge incontinence, if frequent "toileting" doesn't help, you are probably going to wet your pants and not be able to do a thing about it. Because of my huge volume voids, I have to pad up with multiple booster pads and a huge plastic diaper otherwise they leak terribly. I do have the Interstim device now which has helped a bit, and frequent trips to the bathroom don't work for me because if there is no sensation, I can't release. I have started cathing if I need to guarantee staying dry for a long period of time and that works. But if I don't cath, I just have to put up with the flooded jeans and briefs. I know this is awfully frustrating but I am only 50 years old and all I can do is try to accept it. I hope something in this long story helps.

 

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Not being a doctor please take this all with a grain of salt. My case is complicated like yours and yes... You can have OAB and bladder retention. In my case urinating normally I would void something like 150ml from a bladder that is smallish. Mine is 250ml when its at the explosion stage according to a urodynamics test. A 1200ml bladder like yours is... WOW. Amazing.

So in my case over active bladder is simple. When it takes 150ml to top off an always half full bladder you go to the bathroom a LOT.

So I do two things. I self Cath (Sounds awful its not) and empty the entire bladder. Retaining urine all the time is not healthy (Repeating what I was told) It leads to UTI and Kidney infections etc. OUCH. I also take an OAB drug so that my smallist bladder is not still making me void 16 times a day or whatever. Its more like 6 or 7 which I think is fairly normal.

Two things to consider and maybe test drive. First even tho it sounds like a horror show give self cathing a try. After some practice its pretty much a non topic. Coloplast makes a nice pocket one called speedi cath. They will send samples if your doctor prescribes them. Another one to try that I like is this new place http://www.compactcath.com/ These are smaller thus nothing poking up out of your pocket. Both are self lubed so no fooling around you just do it.

For the OAB stuff maybe consider this drug Myrbetriq. I tried some older ones first but didn't have much luck. I'm not sure how Canada does new meds or Caths. Someone suggested they wanted patients to reuse caths which... sounds scary.

Oh! One last word of wisdom (Or possibly dumbness) Use BZT wipes if you cath. Some doctors talk about it others seem to pass over that. If NOTHING else wash your hands before. UTIs are a bitch. And thankfully I've never had one from Cathing.