Chronic Urinary Retention Treatment in Singapore

If you’re experiencing difficulty emptying your bladder completely or feel like you constantly need to urinate despite just going, you may be dealing with chronic urinary retention. This condition can impact your daily activities and quality of life. Our MOH-accredited urologist understands the challenges you face and provides comprehensive evaluation and evidence-based treatment options tailored to your specific situation. With proper diagnosis and management, most patients experience improvement in their symptoms and overall well-being.

Chronic urinary retention is a medical condition where the bladder cannot empty completely during urination, causing urine to remain in the bladder after voiding. Unlike acute urinary retention which develops suddenly and requires emergency treatment, chronic retention develops gradually over time and may initially go unnoticed. This condition affects both men and women, though it’s more common in older males due to prostate-related issues. In Singapore, studies indicate that approximately 10-15% of men over 60 experience some degree of chronic urinary retention. The condition occurs when the normal flow of urine from the bladder through the urethra is partially obstructed or when the bladder muscles cannot contract effectively.

Causes

In Men:

• Benign prostatic hyperplasia (enlarged prostate)
• Prostate cancer
• Urethral strictures from injury or infection
• Previous prostate or bladder surgery complications
• Bladder stones blocking the outlet

In Women:

• Pelvic organ prolapse (cystocele, rectocele)
• Previous pelvic surgery affecting bladder nerves
• Severe constipation causing compression
• Urethral strictures from childbirth trauma
• Endometriosis affecting bladder function

In Both Genders:

• Neurological conditions (Parkinson’s, MS, stroke)
• Diabetes causing nerve damage
• Spinal cord injuries or disorders
• Certain medications affecting bladder function
• Severe urinary tract infections

Risk Factors

• Age over 50 (risk increases with age)
• History of urological surgeries
• Chronic constipation
• Long-term catheter use
• Heavy lifting or straining activities
• Obesity
• Smoking (affects bladder health)
• Family history of urological conditions
• Prolonged sitting or sedentary lifestyle
• Certain occupations requiring delayed voiding

Mild Symptoms

• Difficulty starting urination
• Weak or interrupted urine stream
• Feeling of incomplete bladder emptying
• Needing to strain to urinate
• Taking longer than usual to finish urinating
• Dribbling after urination ends

Moderate Symptoms

• Frequent urination (more than 8 times daily)
• Urgent need to urinate with little output
• Waking multiple times at night to urinate
• Recurring urinary tract infections
• Lower abdominal discomfort or pressure
• Overflow incontinence (involuntary leakage)

Severe Symptoms

• Complete inability to urinate at times
• Severe abdominal pain and distension
• Blood in urine (haematuria)
• Kidney pain or back pain
• Fever with urinary symptoms
• Confusion or altered mental state (in elderly)

Symptoms of chronic urinary retention typically develop gradually over months or years. Many patients adapt to their symptoms without realising the severity until complications arise.

You should consult a urologist if you experience persistent difficulty emptying your bladder, frequent urination that disrupts daily activities, or recurring urinary tract infections. Immediate medical attention is necessary if you develop complete inability to urinate, severe abdominal pain, blood in urine, or fever with urinary symptoms. These may indicate acute retention or complications requiring urgent treatment.

Early consultation is beneficial even for mild symptoms. Chronic urinary retention often worsens gradually, and early intervention can prevent serious complications like kidney damage or bladder stones. During your first consultation, our urologist will conduct a thorough medical history review, physical examination, and order appropriate tests to determine the underlying cause. Many patients report feeling relieved after addressing symptoms they’ve tolerated for years.

The consultation process is straightforward and respectful of your privacy. You’ll discuss your symptoms, medical history, and how the condition affects your daily life. This information helps create a personalised treatment plan suited to your specific needs and lifestyle.

Accurate diagnosis begins with a comprehensive medical history and physical examination. For men, this includes a digital rectal examination to assess prostate size and consistency. Women may undergo a pelvic examination to check for prolapse or other abnormalities.

Uroflowmetry measures your urine flow rate and pattern by having you urinate into a special device. This non-invasive test helps identify weak flow or intermittent patterns typical of retention. The test takes only a few minutes and requires no special preparation besides arriving with a comfortably full bladder.

Post-void residual (PVR) measurement uses ultrasound to determine how much urine remains in your bladder after urination. Normal PVR is less than 50ml; volumes over 200ml indicate significant retention. This painless scan is performed immediately after you urinate normally.

Urodynamic studies provide detailed information about bladder pressure, capacity, and muscle function during filling and emptying. While more invasive than other tests, these studies offer crucial insights for complex cases or when initial treatments haven’t succeeded.

Additional tests may include urine analysis to check for infection, blood tests to assess kidney function, and imaging studies like CT scans or cystoscopy to visualise the urinary tract directly. Results are typically available within days, allowing prompt treatment planning.

Untreated chronic urinary retention progressively damages the urinary system. The constant presence of residual urine creates an ideal environment for bacterial growth, leading to recurring urinary tract infections. These infections can ascend to the kidneys, causing pyelonephritis and potential kidney damage.

Prolonged retention causes the bladder to stretch beyond normal capacity, weakening the muscle and reducing its ability to contract effectively. This creates a vicious cycle where retention worsens over time. Some patients develop bladder stones from crystallised minerals in stagnant urine, causing pain, bleeding, and further obstruction.

The most serious complication is bilateral hydronephrosis, where backed-up urine causes kidney swelling and progressive kidney failure. This develops silently over months or years, often detected only through blood tests showing elevated creatinine levels. Early treatment prevents these irreversible complications and preserves kidney function.

While not all causes of chronic urinary retention are preventable, several strategies reduce risk and slow progression. Maintaining a healthy weight reduces pressure on the bladder and pelvic organs. Regular physical activity, particularly exercises strengthening the pelvic floor, supports proper bladder function.

For men, regular prostate health screenings after age 50 enable early detection and management of prostate enlargement. Prompt treatment of urinary tract infections prevents scarring and stricture formation. Avoiding prolonged sitting and taking regular bathroom breaks prevents overdistension of the bladder.

Dietary modifications can help, including limiting caffeine and alcohol which irritate the bladder. Adequate hydration maintains healthy urine flow without overloading the bladder. Managing chronic conditions like diabetes through proper medication and lifestyle choices protects nerve function essential for normal urination.

Chronic urinary retention is a manageable condition with numerous effective treatment options available. From medications to minimally invasive procedures and modern surgical techniques, contemporary urology offers solutions tailored to each patient’s specific needs. The key to successful treatment lies in accurate diagnosis and selecting the most appropriate intervention based on the underlying cause, severity of symptoms, and individual factors.

Living with untreated chronic urinary retention unnecessarily impacts your quality of life and risks serious complications. With proper medical care, most patients achieve symptom relief and prevent long-term damage to their urinary system. Our MOH-accredited urologist combines years of experience with current treatment modalities to provide comprehensive care throughout your treatment journey.