Kidney Health: Risks Linked to Urinary Retention, Distended Bladder

Urologists will tend to get to the point about urinary retention, minus any medical terminology. “The more you pee, the better your kidney health will be,” said Raymond Leveillee, M.D., a urologist and urologic oncologist with Bethesda Hospital East, a part of Baptist Health.

Healthy kidneys filter about a half cup of blood every minute, removing wastes and extra water to make urine, according to the National Institute of Diabetes and Digestive and Kidney Diseases, part of the National Institutes of Health (NIH). The urine flows from the kidneys to the bladder through two thin tubes of muscle called ureters, one on each side of your bladder. The bladder stores urine. The  kidneys, ureters, and bladder are part of your urinary tract.

Raymond Leveillee, M.D., a urologist and urologic oncologist with Bethesda Hospital East, a part of Baptist Health..

“If someone delays emptying their bladder, I'm talking for hours and hours on end, it can lead to something called bladder over-distension and urinary retention,” explains Dr. Leveillee, who treats a range of urologic conditions including kidney, prostate and renal diseases and cancers of the reproductive and urinary system. He specializes in minimally invasive surgery, endourology (a treatment for urology and kidney stones) and robotic surgery.

Bladder over-distension, or a distended bladder, occurs when the bladder stretches to hold more fluid than normal because of urinary retention, or not urinating enough or at all.

As adults age, men are more likely to experience urinary retention than women, especially as the prostate can cause blockage of the bladder as it grows larger in older men. About 10 percent of men in their 70s experience urinary retention.

“If you combine that with advanced age and a large prostate, as naturally occurs with men, this can lead to retention, formation of bladder stones, infection problems, or in worst-case scenarios, the inability to urinate at all,” said Dr. Leveillee.

The symptoms of urinary retention can range from severe abdominal pain and the inability to urinate, to few or no symptoms at all. “Urinary retention results from either a blockage that partially or fully prevents the flow of urine, or your bladder not being able to maintain a strong enough force to expel all the urine” states the NIH.

This condition can be acute or chronic, according to the American Academy of Family Physicians (AAFP). Causes of urinary retention are numerous and can be classified as obstructive, infectious and inflammatory, pharmacologic, neurologic, or other.

The most common cause of urinary retention for men is benign prostatic hyperplasia (noncancerous enlargement of the prostate gland that's common in older men). Other common causes include prostatitis (prostate inflammation), cystitis (bladder inflammation and the most common type of urinary tract infection), urethritis (bacterial or viral infection that causes swelling and irritation of the urethra), and vulvovaginitis (inflammation and irritation of the female genital area, including the vulva). Obstructive causes in women often involve the pelvic organs.

As women age, they may become more prone to urinary problems such as recurrent urinary tract infections (UTIs), urinary incontinence, overactive bladder and pelvic organ prolapse. But the good news is that women don’t have to live with their symptoms, as most of these conditions are treatable with surgery, medication or changes to lifestyle and diet, according to a urologist with Baptist Health South Florida.

Lunan Ji, M.D., a urologist with Baptist Health, specializes in general, reconstructive and female urology, and is experienced in robotic and minimally invasive surgery. “UTIs are very common infections,” Dr. Ji says. “They occur when bacteria – usually from the skin or the rectum – enter the urethra and infect the urinary tract.”

A bladder infection, or cystitis, is one of the most common types of UTIs, he says. If not treated promptly, the infection can travel up to the kidneys and cause more serious problems, such as a kidney infection, or pyelonephritis, another type of UTI. “Kidney infections are less common than bladder infections but tend to be more serious,” Dr. Ji says.