Introduction
Difficulty in passing urine is a common problem. Many patients have to wait for some time before they can pass urine. Some other patients are unable to completely empty their bladder, causing a constant urge to pass urine. In severe cases (urine retention), some patients are totally unable to pass urine and need insertion of urine catheter to help them pass urine.
It is important to recognize this problem because it can lead to kidney infection and damage, which are life-threatening conditions.
What are the causes of difficulty in passing urine?
Blockage of Urine Flow
Benign Prostatic Hyperplasia (BPH), bladder tumour and bladder stone can cause obstruction to the flow of urine out of the bladder. BPH refers to enlargement of the prostate gland which is most commonly seen among elderly man.
Medications
It is important to go through the patient’s list of medications as some medications can affect the bladder function. An example is Amitryptiline, a medication that is used in the treatment of Migraine, Anxiety and Depression. Another example is Benzhexol (Artane), one of the medications which relieve the symptoms of Parkinson’s disease.
Neurological Disorders
It is important to know that neurological disorders can also cause difficulty in passing urine and urine retention. The mechanism of passing urine is controlled by the brain and spinal cord. In fact, almost everything that we do is controlled by the brain, such as walking, speaking, sleeping, eating and drinking. When difficulty in passing urine is caused by brain and spinal cord disorders, it is referred to as Neurogenic bladder.
There is a long list of causes of Neurogenic bladder, such as Stroke, Parkinson’s disease, Head Injury, Spinal cord injury and Spinal cord compression (Tumour).
Why is it important to diagnose difficulty in passing urine and urine retention?
Due to difficulty in passing urine, the urine remains in the bladder for too long, which results in bladder infection. In severe cases, the germs in the bladder can travel to the kidneys, and cause kidney infection and damage.
Prolonged obstruction to the urine flow can also cause the kidneys to be swollen (Hydronephrosis).
What will the Neurologist do for patients with difficulty in passing urine?
The Neurologist will perform physical examination, blood tests, Ultrasound scan of kidneys / bladder and MRI scan of the brain / spinal cord.
Some patients will be referred to the Urologist (doctors who specialize in treating Prostate disorders and kidney stone).
A sample of urine will be tested for urine infection. If confirmed, the doctor will start antibiotic treatment.
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