It can be frightening for a young person to experience any type of urinary leakage. However, adult bedwetting, also known as nocturnal enuresis, is a common condition that can cause embarrassment.
Urinary retention is a medical condition characterised by the inability to empty the bladder completely. According to Dr Mxolisi Xulu from Mthatha in the Eastern Cape, it can be categorised as either acute or chronic.
He adds that the causes can be either mechanical or functional.
Examining the root causes
“People who are experiencing acute urinary retention show a sudden and distressing inability to urinate. This is often accompanied by tenderness and a visibly swollen bladder upon examination.”
On the other hand, people who experience chronic urinary retention often face difficulties in completely emptying their bladder, but they typically do not experience any pain, explains Xulu.
“Urinary retention in young people can be caused by various factors, including mechanical or functional obstruction, and psychological factors.”
Furthermore, it can be caused by various medications, such as antipsychotics, antidepressants, anticholinergic respiratory agents, opioids, anaesthetics, alpha-adrenoceptor agonists, benzodiazepines, NSAIDs, detrusor relaxants, and calcium channel antagonists.
Look after your bladder
Sihle Skele, a nurse in the Eastern Cape’s Empilisweni District Hospital in Sterkspruit, advises teenagers and adults to drink at least eight glasses or 2 litres of water every day.
He emphasises that the bladder and kidneys require water to flush out the urinary tract and keep everything running smoothly.
“If we do not drink enough water, we become dehydrated, which results in concentrated urine and decreased urine output.”
He suggests that we should not wait until we feel the pressure to urinate.
“Do not wait until your bladder is full and causing pain before urinating. Urinate as soon as you feel the need.”
Nurse Sihle Skele
Bladder training from a young age
Skele emphasises that bladder challenges are a condition that requires attention even from young children. He believes that kids must be trained to cease bedwetting. Fluids should be avoided at least 3-4 hours before night beginning at the age of two.
“When children get into a routine, it’s easy to tell if they need medical attention or not.”
Some children have neurodevelopment disorders, thus parents must pay close attention to them from an early age, he explains. “A psychologist’s consultation is recommended just to figure out where the difficulties are coming from.”
Complications lying in wait
According to Xulu, acute kidney injury can occur in patients with acute on chronic retention. This can potentially result in chronic kidney injury if there are multiple episodes of retention that lead to renal scarring.
Drinking excessive amounts of alcohol can also contribute to acute urinary retention, he says.
He explains that the reason for this phenomenon is that when blood alcohol concentration is high, it affects the cerebral cortex and certain nerve centres responsible for regulating urination.
This leads to disruptions in consciousness, causing people who consume alcohol to not feel the urge to urinate. As a result, their bladder capacity exceeds the normal limit.
“Alcohol acts as a diuretic, promoting the excretion of water through urine. This happens by suppressing the production of a hormone known as vasopressin, which significantly contributes to the control of water excretion.”
Dr Mxolisi Xulu
“In general, alcohol does not cause bladder leaks. However, if you already have a bladder problem, such as stress urinary incontinence (SUI) or an overactive bladder, consuming alcohol may worsen your symptoms,” Xulu cautions.
Treatment options
The treatment options for urinary retention vary depending on the underlying cause and whether the condition is acute or chronic.
“The treatments for urinary retention may involve various approaches such as bladder drainage, medication, medical procedures or devices, surgical intervention, and self-care treatments.”
Dr Mxolisi Xulu
“The goal is to decompress the bladder and provide relief to the patient.”
Even though it may not always be possible to completely prevent urinary retention, there are several steps you can take to maintain a healthy bladder: By staying aware of your body and bathroom habits, following prescribed medication regimens, engaging in exercises to strengthen your pelvic floor muscles, and making nutritious dietary choices, you can contribute to the overall well-being of your bladder.
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