Inability to pass urine
A full, painful bladder that will not empty is an emergency, not something to sleep on.
What it may mean
Acute retention is intensely painful and does not resolve on its own. The bladder needs to be drained with a catheter, and that should happen in hours rather than being endured overnight.
Chronic retention is more insidious. The bladder slowly stops emptying, often without much pain, and the back pressure can quietly damage the kidneys. It is sometimes only picked up when a blood test shows a rising creatinine.
What happens next
- Immediate catheterisation to relieve the bladder
- Blood tests to check kidney function
- Ultrasound of the kidneys and bladder
- Assessment of the underlying cause, most often prostatic obstruction
Prostate enlargement (BPH)
Medical therapy through to laser enucleation and TURP, chosen against your symptom burden rather than prostate size alone.
If this is happening now
Complete inability to pass urine, visible blood in the urine, or severe one-sided flank pain with fever need same-day assessment. Attend your nearest emergency department.