The feeling that the bladder has not been emptied fully – Causes, Diagnosis & Treatment

Causes:

• Benign Prostatic Hyperplasia (BPH): An enlarged prostate gland can compress the urethra, making it difficult to empty the bladder completely. Common in older men.
• Prostate Cancer: Can also cause urinary retention symptoms.
• Urethral Stricture: A narrowing of the urethra, often due to past infection or injury.
• Neurogenic Bladder: Damage to the nerves controlling the bladder can impair its ability to contract and empty properly. This can be caused by conditions like diabetes, spinal cord injury, or multiple sclerosis.
• Medications: Certain medications, such as anticholinergics or some antidepressants, can interfere with bladder emptying.
• Urinary Tract Infection (UTI): Infections can sometimes cause inflammation that affects bladder function.
• Constipation: Severe constipation can sometimes put pressure on the bladder and urethra, making it difficult to empty completely.
• Bladder Stones: Stones in the bladder can obstruct urine flow.

Diagnosis:

• Medical History: Gathering information about urinary symptoms (frequency, urgency, hesitancy, weak stream), other medical conditions, medications, and past surgeries.
• Physical Exam: Including a digital rectal exam (DRE) to assess the prostate gland in men.
• Urine Tests: To check for infection or other abnormalities.
• Post-Void Residual (PVR) Measurement: Measures the amount of urine left in the bladder after urination, helping to determine if the bladder is emptying completely.
• Urodynamic Studies: Tests that assess bladder function and urine flow.
• Cystoscopy: A procedure where a thin tube with a camera is inserted into the urethra to visualize the bladder and urethra.
• Imaging: Ultrasound or CT scan of the urinary tract may be used in some cases.

Treatment:

• BPH: Treatment options include medications (alpha-blockers, 5-alpha reductase inhibitors), minimally invasive procedures (like TURP), or surgery.
• Prostate Cancer: Treatment depends on the stage and type of cancer and may involve surgery, radiation therapy, or hormone therapy.
• Urethral Stricture: Treatment usually involves dilating the urethra or surgery to remove the stricture.
• Neurogenic Bladder: Treatment will depend on the underlying cause and may involve medications, intermittent catheterization, or other therapies.
• Medication Adjustment: If medication is contributing to urinary retention, the doctor may adjust the dose or recommend an alternative.
• UTI: Antibiotics are prescribed to treat UTIs.
• Constipation: Addressing constipation with dietary changes, increased fluid intake, and laxatives can help.
• Bladder Stones: Treatment usually involves removing the stones, either through cystoscopy or other procedures.

Important Considerations:

• If you are experiencing significant urinary retention or are unable to urinate at all, seek immediate medical attention. This is a medical emergency.
• Consult a healthcare professional for persistent or bothersome symptoms of incomplete bladder emptying. Do not attempt to self-treat without consulting a doctor. Early diagnosis is essential for effective treatment and to prevent complications.