{"id":3130,"date":"2021-05-28T08:00:00","date_gmt":"2021-05-28T01:00:00","guid":{"rendered":"https:\/\/drsoaraweeurology.com\/?p=3130"},"modified":"2026-08-29T06:31:26","modified_gmt":"2026-08-28T23:31:26","slug":"%e1%80%9a%e1%80%ac%e1%80%9a%e1%80%ae%e1%80%86%e1%80%ae%e1%80%b8%e1%80%91%e1%80%ad%e1%80%94%e1%80%ba%e1%80%b8%e1%80%81%e1%80%bc%e1%80%84%e1%80%ba%e1%80%b8%e1%81%8b","status":"publish","type":"post","link":"https:\/\/drsoaraweeurology.com\/my\/2021\/05\/28\/transient-urinary-retention\/","title":{"rendered":"\u1006\u102e\u1038\u1019\u101e\u103d\u102c\u1038\u1014\u102d\u102f\u1004\u103a\u1001\u103c\u1004\u103a\u1038 \u101b\u102f\u1010\u103a\u1010\u101b\u1000\u103a\u1016\u103c\u1005\u103a\u1015\u1031\u102b\u103a\u1001\u103c\u1004\u103a\u1038 - \u1015\u103c\u1014\u103a\u101c\u100a\u103a\u1000\u1031\u102c\u1004\u103a\u1038\u1019\u103d\u1014\u103a\u1014\u102d\u102f\u1004\u103a\u101e\u1031\u102c \u1021\u1000\u103c\u1031\u102c\u1004\u103a\u1038\u101b\u1004\u103a\u1038\u1019\u103b\u102c\u1038\u1014\u103e\u1004\u1037\u103a \u1021\u1018\u101a\u103a\u1000\u103c\u1031\u102c\u1004\u1037\u103a \u1001\u103b\u1000\u103a\u1001\u103b\u1004\u103a\u1038\u1000\u102f\u101e\u1019\u103e\u102f\u1001\u1036\u101a\u1030\u101b\u1014\u103a \u101c\u102d\u102f\u1021\u1015\u103a\u101e\u1014\u100a\u103a\u1038"},"content":{"rendered":"\n<div class=\"wp-block-columns coblocks-author-columns has-background is-layout-flex wp-container-core-columns-is-layout-52275889 wp-block-columns-is-layout-flex\" style=\"background-color:#8C8C971A;padding-top:2.5rem;padding-right:2.5rem;padding-bottom:2.5rem;padding-left:2.5rem\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:25%\">\n<figure class=\"wp-block-image size-full is-style-rounded\"><img data-recalc-dims=\"1\" fetchpriority=\"high\" decoding=\"async\" width=\"800\" height=\"800\" data-attachment-id=\"7037\" 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is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:75%\">\n<p class=\"wp-block-paragraph\"><strong><a href=\"https:\/\/drsoaraweeurology.com\/\" target=\"_blank\" rel=\"noreferrer noopener\">Soarawee Weerasopone, Urologist<\/a><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\" target=\"_blank\" rel=\"noreferrer noopener\">Bangkok hospital Headquarter, Bangkok<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"tel:+66880221445\" target=\"_blank\" rel=\"noreferrer noopener\">Samitivej Sriracha Hospital \u2014 Urology department: <strong>088-022-1445<\/strong><\/a><\/p>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button is-style-outline is-style-outline--1\"><a class=\"wp-block-button__link has-background-background-color has-text-color has-background has-link-color has-small-font-size 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onmouseout=\"this.style.transform='scale(1)'\">\n    <svg width=\"28\" height=\"28\" viewBox=\"0 0 24 24\" fill=\"currentColor\">\n      <path d=\"M5.242 13.769L0.5 9.5 12 1l11.5 8.5-4.742 4.269C17.548 11.249 14.978 9.5 12 9.5c-2.977 0-5.548 1.748-6.758 4.269zM12 10a7 7 0 1 0 0 14 7 7 0 0 0 0-14z\"\/>\n    <\/svg>\n  <\/a>\n  \n<\/div>\n\n\n\n<h2 class=\"wp-block-heading\">If you cannot pass urine right now<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Go to hospital today.<\/strong> A bladder that cannot empty is painful, it does not resolve by waiting, and prolonged obstruction damages the kidneys. Drainage with a catheter relieves it within minutes, and everything else on this page \u2014 working out why it happened \u2014 comes afterwards.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">An earlier version of this article discussed reversible causes at length without saying this anywhere. In an emergency in Thailand, call <strong>1669<\/strong>.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Urology center Bangkok hospital Thailand\u00a0<a href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\" target=\"_blank\" rel=\"noreferrer noopener\">Booking online<\/a>\u00a0<a href=\"tel:02-310-3009\">02-310-3009<\/a>\u00a0<a href=\"mailto:bhquro@bdms.co.th\">bhquro@bdms.co.th<\/a><\/li>\n\n\n\n<li>Samitivej Sriracha hospital Chonburi&nbsp;<a href=\"tel:088-022-1445\">088-022-1445<\/a><\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Why finding the trigger matters<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">In men, the background cause is usually a prostate that has been gradually obstructing for years \u2014 see <a href=\"https:\/\/drsoaraweeurology.com\/2020\/08\/28\/benign-prostate-bph\/\">benign prostatic enlargement<\/a>. But a prostate that has been slowly enlarging for a decade does not suddenly stop working on a Tuesday. Something usually tips it over, and that something is often correctable.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This matters practically. Where a clear trigger is found and removed, many men pass urine normally after the catheter comes out and need nothing further. Where no trigger is found, retention is more likely to recur and the underlying obstruction usually needs treating. The fuller account of the causes themselves is in <a href=\"https:\/\/drsoaraweeurology.com\/2020\/10\/21\/male-urinary-retention\/\">acute urinary retention in men<\/a>.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">The correctable triggers<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">Medicines \u2014 the commonest, and the most avoidable<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Cold and flu remedies containing a decongestant<\/strong> such as pseudoephedrine or phenylephrine. These tighten the bladder outlet, and in a man with an enlarged prostate they are a classic precipitant of a first episode of retention. <strong>This was missing from the earlier version of this article entirely<\/strong>, and it is the one worth knowing about, because these are bought without a prescription by men who have no idea they carry the risk.<\/li>\n\n\n<li><strong>Antihistamines<\/strong>, particularly the older sedating type found in the same cold remedies \u2014 they relax the bladder muscle.<\/li>\n\n\n<li><strong>Anticholinergic drugs<\/strong>, including bladder medicines for an overactive bladder, some drugs for nausea and vertigo, and some for Parkinson&#8217;s disease.<\/li>\n\n\n<li><strong>Opioid painkillers<\/strong>, and anaesthesia \u2014 retention after an operation is common enough to be routine.<\/li>\n\n\n<li><strong>Tricyclic antidepressants<\/strong> and some other psychiatric medicines.<\/li>\n\n\n<li><strong>A heavy episode of alcohol<\/strong>, which fills the bladder quickly while blunting the reflex to empty it.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Two corrections here. The earlier version listed <strong>antihypertensives<\/strong> and <strong>NSAIDs<\/strong> among the causes; neither is a well-established precipitant of retention, and both have been removed. Decongestants, antihistamines and anticholinergics \u2014 the ones that genuinely matter \u2014 were largely absent.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"800\" height=\"450\" data-attachment-id=\"3139\" data-permalink=\"https:\/\/drsoaraweeurology.com\/my\/2021\/05\/28\/transient-urinary-retention\/pill\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/Pill.jpg?fit=1200%2C675&amp;ssl=1\" data-orig-size=\"1200,675\" data-comments-opened=\"1\" data-image-meta=\"{&quot;copyright&quot;:&quot;Freepik Company S.L. - www.freepik.com&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Several medications have a negative effect on urinary function.\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Several medications have a negative effect on urinary function.&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/Pill.jpg?fit=800%2C450&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/Pill.jpg?resize=800%2C450&#038;ssl=1\" alt=\"Assorted medicines, several classes of which can precipitate acute urinary retention\" class=\"wp-image-3139\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/Pill.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/Pill.jpg?resize=300%2C169&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/Pill.jpg?resize=1024%2C576&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/Pill.jpg?resize=768%2C432&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/Pill.jpg?resize=16%2C9&amp;ssl=1 16w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">An over-the-counter cold remedy is one of the commonest triggers of a first episode \u2014 and one of the easiest to avoid.<\/figcaption><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\">Constipation<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">A loaded rectum presses on the bladder outlet, and clearing it sometimes resolves the retention on its own. Easily missed, easily fixed, and worth asking about in anyone who is immobile or on opioids \u2014 both of which cause constipation and retention at the same time.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"800\" height=\"534\" data-attachment-id=\"3137\" data-permalink=\"https:\/\/drsoaraweeurology.com\/my\/2021\/05\/28\/transient-urinary-retention\/old-man-holding-belly-stomach-ache-hurts-patient\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/Constipation.jpg?fit=1200%2C801&amp;ssl=1\" data-orig-size=\"1200,801\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;1.8&quot;,&quot;camera&quot;:&quot;NIKON D810&quot;,&quot;caption&quot;:&quot;Senior Man Holding Belly. Stomach Ache Hurts Elderly Patient. Pancreatitis Symptom. Abdominal Pain in Pensioner. Gastroenterology. Constipation, Unhealthy Food. Old Man Suffering Cramp, Dyspepsia.&quot;,&quot;created_timestamp&quot;:&quot;1523969637&quot;,&quot;focal_length&quot;:&quot;50&quot;,&quot;iso&quot;:&quot;125&quot;,&quot;shutter_speed&quot;:&quot;0.003125&quot;,&quot;title&quot;:&quot;Old Man Holding Belly Stomach Ache Hurts Patient.&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Constipation is easily correctable cause in transient urinary incontinence.\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Constipation is easily correctable cause in transient urinary incontinence. &lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/Constipation.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/Constipation.jpg?resize=800%2C534&#038;ssl=1\" alt=\"Abdominal discomfort from constipation, a correctable contributor to urinary retention\" class=\"wp-image-3137\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/Constipation.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/Constipation.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/Constipation.jpg?resize=1024%2C684&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/Constipation.jpg?resize=768%2C513&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/Constipation.jpg?resize=16%2C12&amp;ssl=1 16w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">A loaded rectum presses on the bladder outlet \u2014 one of the simplest things to correct.<\/figcaption><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\">Infection and inflammation<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/drsoaraweeurology.com\/2020\/07\/24\/what-is-acute-prostate-infection\/\">Prostatitis<\/a> in particular can cause retention outright, and any urinary infection can tip a marginal bladder over. Fever with retention needs urgent attention rather than a routine appointment.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Being unwell, immobile, or recently operated on<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Bed rest, a general anaesthetic, post-operative pain relief and an unfamiliar environment combine, which is why retention is so common in hospital. It is also why the episode that happens in hospital does not always mean the prostate needs treating.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"533\" data-attachment-id=\"3138\" data-permalink=\"https:\/\/drsoaraweeurology.com\/my\/2021\/05\/28\/transient-urinary-retention\/woman-checking-fever-temperature-of-senior-sick-man-lying-on-bed\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/Illness.jpg?fit=1200%2C800&amp;ssl=1\" data-orig-size=\"1200,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;2.8&quot;,&quot;camera&quot;:&quot;Canon EOS R&quot;,&quot;caption&quot;:&quot;female checking fever temperature of senior man lying on bed. mature husband feeling symptoms of the flu while wife checking fever by touching forehead. at home&quot;,&quot;created_timestamp&quot;:&quot;1604587039&quot;,&quot;focal_length&quot;:&quot;50&quot;,&quot;iso&quot;:&quot;800&quot;,&quot;shutter_speed&quot;:&quot;0.00625&quot;,&quot;title&quot;:&quot;woman checking fever temperature of senior sick man lying on bed&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Any non urinary-related illness can affect urinary function.\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Any non urinary-related illness can affect urinary function.&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/Illness.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/Illness.jpg?resize=800%2C533&#038;ssl=1\" alt=\"Patient unwell in bed, a situation in which urinary retention frequently occurs\" class=\"wp-image-3138\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/Illness.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/Illness.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/Illness.jpg?resize=1024%2C683&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/Illness.jpg?resize=768%2C512&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/Illness.jpg?resize=16%2C12&amp;ssl=1 16w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Illness, bed rest and an anaesthetic together account for a large share of episodes.<\/figcaption><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\">The checklist used in clinic: DIAPPERS<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">To make sure none of the above is missed, the reversible contributors are worked through as a checklist using the mnemonic <strong>DIAPPERS<\/strong>. It comes originally from the assessment of transient urinary <em>incontinence<\/em>, and it is used here in the same spirit \u2014 as a systematic sweep for the reversible things that tip a marginal bladder over, so that none is overlooked in a patient who is uncomfortable and being dealt with quickly.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">What happens after the catheter goes in<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>The volume drained is recorded.<\/strong> A very large volume suggests the bladder had been struggling for a long time rather than failing suddenly \u2014 but it is worth knowing that <strong>there is no agreed volume above which retention counts as chronic<\/strong>. The formal definitions use the urine left <em>after<\/em> passing water rather than what comes out through the first catheter, and even those differ between guidelines: one uses more than 300 ml on at least two occasions over six months, another sets the mark at a litre. Kidney function, whether the kidneys are swollen on a scan, and repeated infections predict how things go better than the drainage figure does.<\/li>\n\n\n<li><strong>Kidney function is checked<\/strong>, since obstruction affects it.<\/li>\n\n\n<li><strong>Occasionally the kidneys produce a great deal of urine for a day or two afterwards.<\/strong> This is post-obstructive diuresis, usually defined as more than 200 ml an hour for two hours running, or more than three litres in a day. In most men it settles within about 24 hours and needs only watching. Beyond about 48 hours it becomes a problem in itself, because losing that much fluid and salt can drop the blood pressure and disturb the body\u2019s chemistry \u2014 which is a legitimate reason to be kept in on fluids and blood tests rather than sent home with a bag. The heaviest diuresis generally happens only when both kidneys, or a single functioning kidney, were completely obstructed.<\/li>\n\n\n<li><strong>A medication to relax the outlet is usually started before the catheter is removed<\/strong>, and it makes a measurable difference: pooled trial data show roughly <strong>60% of men pass urine successfully after the catheter comes out when an alpha-blocker has been given, against roughly 38% without one<\/strong>, and it also reduces the chance of going back into retention afterwards. It is one of the better-supported small interventions in urology, and reasonable to ask about if nobody has mentioned it.<\/li>\n\n\n<li><strong>The catheter is removed after a few days<\/strong> and you are watched to see whether you can void. If that fails, it is repeated later or the underlying obstruction is treated \u2014 see <a href=\"https:\/\/drsoaraweeurology.com\/2022\/09\/29\/water-vapor-therapy-bph\/\">water vapour therapy<\/a> and the other options for an obstructing prostate.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">One caution worth stating, because it is the reason assessment matters more than the choice of treatment: <strong>a weak or underactive bladder produces the same picture as an obstructed outlet<\/strong>, and operating on the prostate of a man whose bladder is the real problem does not help him. That distinction is made on <a href=\"https:\/\/drsoaraweeurology.com\/2023\/04\/23\/uroflowmetry\/\">flow testing<\/a> and, where it matters, pressure studies.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Symptoms that need attention the same day<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Being unable to pass urine at all<\/strong>, with a painful full lower abdomen.<\/li>\n\n\n<li><strong>Fever or shaking chills<\/strong> alongside difficulty passing urine.<\/li>\n\n\n<li><strong>Passing only small amounts frequently, with constant dribbling<\/strong> \u2014 this can be a full bladder overflowing rather than an improvement, and it is easily mistaken for the opposite problem.<\/li>\n\n\n<li><strong>New leg weakness or numbness, numbness around the buttocks or genitals, or loss of bowel control<\/strong> alongside retention. This suggests pressure on the nerves of the spine and is an emergency measured in hours.<\/li>\n\n\n<li>A catheter that stops draining.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Frequently Asked Questions<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">I cannot pass urine. Can it wait until tomorrow?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">No. It is painful, it will not resolve by itself, and prolonged obstruction damages the kidneys. Drainage with a catheter relieves it within minutes. Investigating why it happened comes afterwards.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Which medicines can bring it on?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Decongestants in cold and flu remedies are the classic trigger and are bought without a prescription. Also older antihistamines, anticholinergic drugs including some bladder and anti-nausea medicines, opioid painkillers, anaesthesia, tricyclic antidepressants, and a heavy episode of drinking. If you have an enlarged prostate, check cold remedies before taking them.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Does a medication before the catheter comes out actually help?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Yes, measurably. Pooled trial data show that with an alpha-blocker started before the catheter is removed, roughly 60% of men pass urine successfully, against roughly 38% without one, and it also reduces the chance of going back into retention. It is reasonable to ask about if it has not been mentioned.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">They drained a huge amount. Does the number mean it is serious?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Only loosely. A large volume suggests the bladder had been struggling for a while rather than failing suddenly, but there is no agreed volume that makes retention officially chronic. The formal definitions use the residual left after voiding rather than the first drainage, and they differ between guidelines \u2014 one uses more than 300 ml on two occasions over six months, another a litre. Kidney function, swelling of the kidneys on imaging and repeated infections tell you more than the drainage figure.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Will I need a prostate operation?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Not necessarily. Where a clear trigger is found and removed \u2014 a medicine, constipation, an infection, an operation \u2014 many men pass urine normally once the catheter comes out and need nothing further. Where no trigger is found, retention tends to recur and the underlying obstruction usually needs treating.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">I am dribbling constantly. Does that mean the blockage has cleared?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Not necessarily, and this catches people out. A very full bladder can overflow, producing constant dribbling that looks like incontinence while the bladder remains obstructed. It needs assessment rather than reassurance.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Does this happen to women?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Much less often, since there is no prostate. When it does, the causes are different \u2014 neurological conditions, pelvic surgery, prolapse, medication, or a bladder that has become underactive \u2014 and it warrants proper investigation rather than being assumed transient.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Arranging a consultation<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">After an episode of retention, Dr. Soarawee Weerasopone sees patients at <a href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\">Bangkok Hospital Headquarters<\/a> and at Samitivej Sriracha Hospital in Chonburi on <a href=\"tel:0880221445\">088-022-1445<\/a>. Bring a list of <strong>everything<\/strong> you take, including cold remedies and anything bought without a prescription, and the record of how much was drained if you have it.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Bangkok Hospital Telemedicine is available for patients who cannot attend in person, including international patients \u2014 arrange it in advance by email to the Urology department at <a href=\"mailto:bhquro@bdms.co.th\">bhquro@bdms.co.th<\/a>. Samitivej Sriracha is in-person only. Enquiries about cost are answered by the hospital, not by this website. <strong>If you cannot pass urine now, go to hospital rather than emailing.<\/strong><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">References<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Fisher E, Subramonian K, Omar MI. The role of alpha blockers prior to removal of urethral catheter for acute urinary retention in men. <em>Cochrane Database Syst Rev<\/em>. 2014;(6):CD006744.<\/li>\n\n\n<li>Karavitakis M, Kyriazis I, Omar MI, et al. Management of urinary retention in patients with benign prostatic obstruction: a systematic review and meta-analysis. <em>Eur Urol<\/em>. 2019;75(5):788\u2013798.<\/li>\n\n\n<li>Stoffel JT, Peterson AC, Sandhu JS, et al. AUA white paper on nonneurogenic chronic urinary retention. <em>J Urol<\/em>. 2017;198(1):153\u2013160.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Disclaimer:<\/strong> This content is written and reviewed by Dr. Soarawee Weerasopone, a board-certified urologist at Bangkok Hospital Headquarters, and is intended for education only. It is not medical advice, diagnosis or a prescription for any individual, and no advice, diagnosis or prescription is given through personal messaging channels or social media. Dr. Soarawee operates no public social media account; any account offering private consultation in his name is fraudulent. In an emergency in Thailand, call <strong>1669<\/strong>.<\/p>\n\n\n\n<script type=\"application\/ld+json\">\n{\n  \"@context\": \"https:\/\/schema.org\",\n  \"@graph\": [\n    {\n      \"@type\": \"MedicalWebPage\",\n      \"@id\": \"https:\/\/drsoaraweeurology.com\/2021\/05\/28\/transient-urinary-retention\/#webpage\",\n      \"url\": \"https:\/\/drsoaraweeurology.com\/2021\/05\/28\/transient-urinary-retention\/\",\n      \"name\": \"Sudden Inability to Pass Urine: Reversible Causes, and Why It Cannot Wait\",\n      \"description\": \"Acute urinary retention requires same-day drainage. Correctable precipitants include decongestants, antihistamines, anticholinergics, opioids, constipation and infection, and an alpha-blocker before catheter removal measurably improves the chance of voiding.\",\n      \"inLanguage\": \"en\",\n      \"datePublished\": \"2021-05-28\",\n      \"dateModified\": \"2026-08-29\",\n      \"lastReviewed\": \"2026-08-29\",\n      \"isPartOf\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#website\" },\n      \"author\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"reviewedBy\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"publisher\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"about\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/2021\/05\/28\/transient-urinary-retention\/#aur\" },\n      \"audience\": { \"@type\": \"MedicalAudience\", \"audienceType\": \"Patient\" },\n      \"citation\": [\n        { \"@type\": \"ScholarlyArticle\", \"name\": \"The role of alpha blockers prior to removal of urethral catheter for acute urinary retention in men\", \"isPartOf\": { \"@type\": \"Periodical\", \"name\": \"Cochrane Database of Systematic Reviews\" }, \"datePublished\": \"2014\", \"identifier\": \"10.1002\/14651858.CD006744.pub3\" },\n        { \"@type\": \"ScholarlyArticle\", \"name\": \"Management of urinary retention in patients with benign prostatic obstruction: a systematic review and meta-analysis\", \"isPartOf\": { \"@type\": \"Periodical\", \"name\": \"European Urology\" }, \"datePublished\": \"2019\", \"identifier\": \"10.1016\/j.eururo.2019.01.046\" },\n        { \"@type\": \"ScholarlyArticle\", \"name\": \"AUA white paper on nonneurogenic chronic urinary retention\", \"isPartOf\": { \"@type\": \"Periodical\", \"name\": \"The Journal of Urology\" }, \"datePublished\": \"2017\", \"identifier\": \"10.1016\/j.juro.2017.01.075\" }\n      ],\n      \"disambiguatingDescription\": \"The earlier version discussed reversible causes without stating anywhere that acute retention is an emergency requiring same-day drainage; that now leads the page. The DIAPPERS mnemonic is retained as the clinic checklist used to sweep systematically for reversible contributors, with a note that it originates in the assessment of transient urinary incontinence. Antihypertensives and NSAIDs were listed as causes and have been removed as not well established, while decongestants, older antihistamines and anticholinergic drugs \u2014 the classic precipitants \u2014 were largely absent and are now given first. Revised 29 August 2026 with sourced figures matching the companion article: an alpha-blocker before trial without catheter gives successful voiding in approximately 60% versus 38% without, and reduces recurrent retention; post-obstructive diuresis is defined as more than 200 ml per hour for two consecutive hours or more than three litres in 24 hours, physiological when self-limited within about 24 hours and pathological beyond about 48 hours; and there is NO validated drained-volume threshold distinguishing acute from chronic retention, since formal definitions use post-void residual and differ between guidelines (300 ml on two occasions over six months versus 1000 ml), with renal function, hydronephrosis and recurrent infection predicting outcome better.\"\n    },\n    {\n      \"@type\": \"MedicalCondition\",\n      \"@id\": \"https:\/\/drsoaraweeurology.com\/2021\/05\/28\/transient-urinary-retention\/#aur\",\n      \"name\": \"Acute urinary retention\",\n      \"description\": \"Sudden inability to pass urine with a painful distended bladder, requiring prompt catheter drainage. In men the usual background cause is benign prostatic obstruction, commonly precipitated by a correctable trigger.\",\n      \"cause\": \"Sympathomimetic decongestants such as pseudoephedrine and phenylephrine; sedating antihistamines; anticholinergic agents; opioid analgesia and general anaesthesia; tricyclic antidepressants; acute alcohol excess; constipation and faecal loading; urinary infection and prostatitis; immobility and recent surgery. Reversible contributors are screened systematically using the DIAPPERS checklist.\",\n      \"possibleComplication\": \"Renal impairment from prolonged obstruction; post-obstructive diuresis following decompression, defined as more than 200 ml per hour for two consecutive hours or more than three litres in 24 hours, physiological when self-limited within about 24 hours and pathological beyond about 48 hours when it risks hypovolaemia, hypotension and electrolyte disturbance; recurrent retention where no reversible trigger is identified; and overflow incontinence mistaken for resolution.\",\n      \"typicalTest\": {\n        \"@type\": \"MedicalTest\",\n        \"name\": \"Measurement of the drained volume and of renal function\",\n        \"description\": \"A large drained volume suggests chronicity but no validated volume threshold distinguishes acute from chronic retention. 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New leg weakness, saddle numbness or loss of bowel control alongside retention suggests cauda equina compression and requires emergency assessment within hours.\"\n    },\n    {\n      \"@type\": \"FAQPage\",\n      \"@id\": \"https:\/\/drsoaraweeurology.com\/2021\/05\/28\/transient-urinary-retention\/#faq\",\n      \"isPartOf\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/2021\/05\/28\/transient-urinary-retention\/#webpage\" },\n      \"mainEntity\": [\n        {\n          \"@type\": \"Question\",\n          \"name\": \"I cannot pass urine. Can it wait until tomorrow?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"No. It is painful, will not resolve by itself, and prolonged obstruction damages the kidneys. Catheter drainage relieves it within minutes, and investigation of the cause follows afterwards.\" }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"Which medicines can bring on urinary retention?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"Decongestants in cold and flu remedies are the classic trigger and are sold without prescription. Also sedating antihistamines, anticholinergic drugs, opioid painkillers, anaesthesia, tricyclic antidepressants and acute alcohol excess.\" }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"Does a medication before the catheter comes out actually help?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"Yes, measurably. Pooled trial data show that with an alpha-blocker started before the catheter is removed, roughly 60% of men pass urine successfully, against roughly 38% without one, and it also reduces the chance of going back into retention.\" }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"They drained a huge amount. Does the number mean it is serious?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"Only loosely. A large volume suggests the bladder had been struggling for a while rather than failing suddenly, but there is no agreed volume that makes retention officially chronic. Formal definitions use the residual left after voiding rather than the first drainage, and they differ between guidelines. Kidney function, swelling of the kidneys on imaging and repeated infections tell you more than the drainage figure.\" }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"Will I need a prostate operation after retention?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"Not necessarily. Where a clear trigger is found and removed, many men void normally once the catheter is out. Where no trigger is identified, retention tends to recur and the underlying obstruction usually needs treating.\" }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"I am dribbling constantly. Does that mean the blockage has cleared?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"Not necessarily. A very full bladder can overflow, producing constant dribbling that resembles incontinence while the bladder remains obstructed. It needs assessment rather than reassurance.\" }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"Does urinary retention happen to women?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"Much less often, since there is no prostate. When it does, the causes are different - neurological conditions, pelvic surgery, prolapse, medication, or a bladder that has become underactive - and it warrants proper investigation rather than being assumed transient.\" }\n        }\n      ]\n    }\n  ]\n}\n<\/script>\n","protected":false},"excerpt":{"rendered":"<p>\u0b95\u0b9f\u0bc1\u0bae\u0bc8\u0baf\u0bbe\u0ba9 \u1006\u102e\u1038\u1015\u102d\u1010\u103a\u1001\u103c\u1004\u103a\u1038\u1000\u102d\u102f \u1011\u102d\u102f\u1014\u1031\u1037\u1001\u103b\u1004\u103a\u1038\u1015\u1004\u103a \u1006\u102e\u1038\u1011\u102f\u1010\u103a\u1015\u1031\u1038\u101b\u1014\u103a \u101c\u102d\u102f\u1021\u1015\u103a\u101e\u100a\u103a - \u104e\u1004\u103a\u1038\u101e\u100a\u103a \u1014\u102c\u1000\u103b\u1004\u103a\u1005\u1031\u1015\u103c\u102e\u1038 \u1019\u1000\u102f\u1018\u1032\u1011\u102c\u1038\u1015\u102b\u1000 \u1000\u103b\u1031\u102c\u1000\u103a\u1000\u1015\u103a\u1000\u102d\u102f \u1011\u102d\u1001\u102d\u102f\u1000\u103a\u1015\u103b\u1000\u103a\u1005\u102e\u1038\u1005\u1031\u1015\u102b\u101e\u100a\u103a\u104b \u101e\u102d\u102f\u1037\u101e\u1031\u102c\u103a \u1016\u103c\u1005\u103a\u1015\u103d\u102c\u1038\u1019\u103e\u102f\u1021\u1019\u103b\u102c\u1038\u1005\u102f\u101e\u100a\u103a \u1006\u1031\u1038\u101d\u102b\u1038\u1010\u1005\u103a\u1019\u103b\u102d\u102f\u1038\u1019\u103b\u102d\u102f\u1038\u104a \u101d\u1019\u103a\u1038\u1001\u103b\u102f\u1015\u103a\u1001\u103c\u1004\u103a\u1038 \u101e\u102d\u102f\u1037\u1019\u101f\u102f\u1010\u103a \u1015\u102d\u102f\u1038\u101d\u1004\u103a\u1001\u103c\u1004\u103a\u1038\u1000\u1032\u1037\u101e\u102d\u102f\u1037\u101e\u1031\u102c \u1015\u103c\u1004\u103a\u1006\u1004\u103a\u1000\u102f\u101e\u1014\u102d\u102f\u1004\u103a\u101e\u100a\u1037\u103a \u1021\u1000\u103c\u1031\u102c\u1004\u103a\u1038\u101b\u1004\u103a\u1038\u1010\u1005\u103a\u1001\u102f\u1001\u102f\u1000\u103c\u1031\u102c\u1004\u1037\u103a \u1016\u103c\u1005\u103a\u1015\u1031\u102b\u103a\u101c\u102c\u1010\u1010\u103a\u1015\u103c\u102e\u1038 \u104e\u1004\u103a\u1038\u1000\u102d\u102f \u101b\u103e\u102c\u1016\u103d\u1031\u1010\u103d\u1031\u1037\u101b\u103e\u102d\u1001\u103c\u1004\u103a\u1038\u1000 \u1014\u1031\u102c\u1000\u103a\u1010\u1005\u103a\u1000\u103c\u102d\u1019\u103a \u1011\u1015\u103a\u1016\u103c\u1005\u103a\u1019\u1016\u103c\u1005\u103a\u1000\u102d\u102f \u1006\u102f\u1036\u1038\u1016\u103c\u1010\u103a\u1015\u1031\u1038\u1015\u102b\u101e\u100a\u103a\u104b.<\/p>","protected":false},"author":185281453,"featured_media":10106,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"advanced_seo_description":"Acute urinary retention is an emergency needing same-day drainage. 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