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Acute urinary retention: what to do

The urge is there but nothing comes, and the pressure in the lower abdomen grows with every hour. This is acute urinary retention, most often in men over 60 with an enlarged prostate, triggered by alcohol, cold or certain tablets. Waiting for it to resolve is not an option: an overfilled bladder is injured and the kidneys suffer within a day.

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What to do right now

Try once
A warm bath or a warm shower on the lower abdomen, the sound of running water, standing or squatting. Five minutes — if nothing happens, stop trying.
Do not drink a lot
Every glass increases the distension and the pain.
Check your medication
Cold remedies with pseudoephedrine, first-generation antihistamines, antispasmodics and some antidepressants trigger retention. Note what was taken.
Call after 6–8 hours
Longer carries a risk of bladder rupture and acute kidney injury. With severe pain, call sooner.
Know what will happen
A soft catheter through the urethra; relief is immediate. The crew does it at home in about fifteen minutes.

Call an ambulance if

No urine for more than 6–8 hours despite the urge
Severe distending pain in the lower abdomen
Retention with fever and chills — infection has joined in
Blood in the urine after attempts to pass it
Retention in a patient with known prostate cancer or after surgery
A repeat episode within a month

What not to do

Do not press on the abdomen
Do not insert anything into the urethra yourself
Do not take diuretics — the bladder is already full
Do not wait until morning if it started in the evening

What the crew does

Examination, palpation of the abdomen, assessment of the cause
Catheterisation with a soft catheter and local anaesthetic; a Foley catheter for several days if needed
Advice on prostate medication and referral to a urologist
Admission to urology if catheterisation fails or infection is present

This page is for information and does not replace a medical examination. If the condition worsens, call the crew: +7 (985) 887-82-52.

This page in Russian: Russian version.

Questions

How much does catheterisation at home cost in Moscow?

Call-out 6,000 ₽ inside the MKAD plus catheterisation by the price list; a Foley catheter with insertion is charged separately. Cheaper than a night in an admissions department.

Will the catheter stay in?

After a first simple episode the bladder is emptied and the catheter removed. With prostate enlargement and repeated retention a Foley catheter is left for several days until a urologist decides between medication and surgery.

Why did it happen after a party?

Alcohol, cold and an overfilled bladder on top of prostate enlargement are the classic trio. See a urologist within days to prevent a repeat.