Urine Retention The inability to empty the bladder. Urine Retention is a common problem in the older adult, commonly related to neurologic / other underlying condition.

Pathophysiology & Etiology Frequently encountered in the acute care setting, post – catheterization, after stroke, in diabetics due to atonic neuropathic bladder, due to fecal impaction, and males with prostatic enlargement. The pt with urine retention may void small amounts / may be incontinent continuously due to overflow of urine.

Pts with urine retention will usually have incontinence during the night. Urine retention may also be caused / aggravated by drugs with anticholinergic properties such as levadopa / the TCA, especially amitriptiline. Urine retention may cause urinary tract infection, which can lead to sepsis in the elderly pt.

Nursing Interventions Remove fecal impaction to help pt regain bladder function. If prostatic disease is suspected, appropriate referral is necessary. Encourage male to use the standing position and female the sitting position to facilitate urinary flow; provide privacy.

If no underlying condition is suspected attempt intermittent catheterizations every 8 hours, in combination with regular voiding attempts by pt. If there is no response in 2 weeks (i.e., no decrease in postvoid residuals), referral to a urologist may be necessary for medical management of the urine retention.