Inability to pass urine, which is retained in the bladder is called ‘Retention’ which condition is totally different from ‘Anuria’ (when kidneys fail to produce urine). In ‘retention’ the urinary bladder fails to excrete urine but in ‘anuria’ there is no presence of urine in the bladder nor any passage of urine but the cause, leading to either of maladies, are totally different. The conditions are quite common in the following category of persons or situa-tions, viz.
“Young persons, old ladies and gents who masturbate quite secretly. This condition is quite common in chronic bach elors, maids, widowers and widows.”
Causes and Symptoms
1. Inability of urinary bladder to void urine.
2. Paralysis of the Nerve filaments so that the patient is unaware of the fullness of bladder.
3. There is no desire or urge but only a sense of fullness.
4. Some drops of urine may escape when the bladder gets greatly distended.
5. Presence of stone, stricture of urethra, narrow and swelled urinary passage (as in Venereal diseases).
6. Typhoid fever, cholera, loose motions etc.
7. Swelling and pain in lower abdomen alongwith abnormal abdominal distension.
8. Pain is unbearable, excruciating and the patient writhes, cries, twists like a screw, is restless and Neurotic.
Treatment
If distension of the bladder is not relieved, it might burst and endanger patient’s life. In some cases the accumulated urine back lashes to the ureters, thus exerting undue pressure on the kidneys. Function of kidneys is not to receive back urine but to discharge it through the ureters. The situation becomes still grave and life threatening when renal function gets interrupted-it might result in bloating of the kidney(s), account for mixing of raw and processed urine which condition may send back toxins to the blood stream.
Mixed conditions create dilemma for the patient and his doctor. As a first step, use catheter to let out easy flow of urine. When the bladder has been voided and urinary flow restored to normalcy, rest ofthe complications will automatically get resolved. Rest ofthe investigations can be taken up to discern the disturbing cause which, when fully detected, can be taken care of by proper follow up treatment. Generally, there may not be any need to re-sort to surgical means but, if the same is thought imperative, let there be no delay. Test results will determine the line and mode of treatment to be followed. Generally a course of antibiotics and diuretics may solve the problem.