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Do you feel like you can't empty your bladder completely, and still have the urge to go to the toilet after you have just urinated? This is called urinary retention, and it has a variety of causes.

We all know what a relief it can be to finally get to the restroom and empty our bladders after holding it in for a while. What if that relief never quite seems to come anymore, though? What if you feel like no matter how hard you try, you can never quite seem to empty your bladder? This phenomenon is called urinary retention — and it can have serious causes. 

If you feel like you are no longer able to empty your bladder completely when you urinate, it's time to see a doctor. We'll the other symptoms you might have, the causes, and the treatment options, below, but no matter what you do next, it should involve making an appointment as soon as possible. 

What Is Urinary Retention?

Urinary retention is condition in which you are not able to void (empty) your bladder all the way. Sometimes, people with urinary retention cannot pee at all — but most of the time, patients are able to urinate; they just feel that their bladder is not completely empty after going to the toilet. This involves a feeling of needing to pee more, but not being able to. 

We can distinguish between two types of urinary retention:

  • Acute urinary retention comes on suddenly and the patient is not able to urinate at all. This requires urgent medical care, as the condition is a medical emergency that can become life-threatening. 
  • Chronic urinary retention is an ongoing condition in which patients are able to urinate but without emptying their bladder completely. It gradually develops over time, and usually with age.

What Are the Symptoms of Urinary Retention?

If you aren't able to empty your bladder completely, you may:

  • Find it hard to get urination started, even though you need to "go". This is called urinary hesitancy. 
  • Pee a little and then find it hard or impossible to finish urinating, even though you still need to "go". 
  • Need to strain to get a flow started.
  • Need to go to the toilet often, even immediately after you've already urinated.
  • Still feel that your bladder is full after peeing.

You may also experience some of these related symptoms:

  • Abdominal pain.
  • Abdominal bloating.
  • Incontinence. You may experience stress incontinence, which means losing a little urine in active situations, such as when laughing, coughing, or jumping.

What Can Cause Trouble with Emptying Your Bladder?

Chronic urinary retention can be caused by a wide variety of factors. They all boil down to either a blockage or an obstruction (meaning a physiological reason why urine cannot leave your bladder to the point where you can void completely), or the bladder not being strong enough to allow all the urine to be voided.

The causes of urinary retention include:

  • Urinary tract infection.
  • Other infections, including sexually transmitted diseases.
  • In men, an enlarged prostate (benign prostatic hyperplasia) — which is very common with advanced age, especially after 80.
  • Pelvic organ prolapse, when the uterus, bladder, bowel, or other internal organs move from their intended place.
  • Constipation. 
  • Urinary tract stones. 
  • Physical blockages like urethral strictures.
  • An underactive bladder, in which the bladder muscles are the problem, is associated with conditions that include Parkinson's disease, multiple sclerosis, diabetes, and pelvic injuries (including resulting from vaginal childbirth), among other conditions.

What Should You Do If You Can't Empty Your Bladder Completely?

If you cannot urinate at all, but have a full bladder, that can be a life-threatening medical emergency. Going to the ER immediately or even calling an ambulance is warranted.

If you cannot empty your bladder completely, but can still pee, you should still make an appointment with your doctor as soon as possible.

Your doctor should ask for a complete medical history, and carefully question you about your symptoms and how long you have been having them. 

You can then expect a full physical exam and lab tests to find out what is causing your urinary retention. Ultrasound will be used in many cases, and your doctor may want to carry out a full range of urodynamic tests to understand why you cannot empty your bladder all the way. 

How Is Urinary Retention Treated?

Once a diagnosis is made, treatment can include:

  • Draining the bladder, reserved for cases in which the patient cannot urinate at all.
  • Medications that can treat urinary retention include antibiotics (if an infection is present) and 5-alpha-reductase inhibitor and an alpha-blockers for men with an enlarged prostate.
  • Treatment for the underlying condition.

There are also things you can do at home to empty your bladder more fully. They include:

  • Drinking more water.
  • Sitting on the toilet to pee — for men as well as women — while leaning forward and with feet firmly on the floor. Sometimes, elevating the feet by using a small step can help to create an angle that promotes bladder emptying.
  • Staying on the toilet for a while after you think you are done. Sometimes, you will be able to pee more.
  • Turning the faucet on while you urinate.
  • Placing a hand firmly on your abdomen, where the bladder is located, and pressing down while you try to pee.
  • Eating a fiber rich diet to reduce the risk of constipation, which can cause urinary retention.

You can immediately try these approaches if you've been feeling like your bladder cannot empty completely, but never stop there — see a doctor, too!

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