Harnstau

Harnstau, known in English as urinary retention, is a condition in which the bladder cannot empty completely or at all, leading to urine accumulation. It may be acute, with sudden inability to urinate, painful bladder distension, and urinary hesitancy, or chronic, with intermittent or incomplete emptying that may go unnoticed for periods. In chronic cases, overflow incontinence can occur.

Causes include mechanical obstruction (benign prostatic hyperplasia in men, urethral stricture, bladder stones), functional disorders (neurogenic bladder from diabetes, spinal cord injury, multiple sclerosis), and drug effects (anticholinergics, opioids, certain antidepressants). Other factors include postoperative or postpartum urinary retention and pelvic organ prolapse in women. In men, prostate-related obstruction is the most common cause.

Diagnosis relies on history and examination, including assessment for abdominal distension and, in men, digital rectal examination. Acute retention is often relieved with catheterization. Investigations may include bladder ultrasound to measure post-void residual, urinalysis to exclude infection, blood tests for renal function, and imaging or urodynamics if obstruction is suspected.

Management aims to relieve retention and address the underlying cause. Immediate catheterization (intermittent or indwelling) is standard for acute retention. For BPH, pharmacologic therapy with alpha-blockers or 5-alpha-reductase inhibitors or surgical options such as TURP may be considered. For urethral strictures or stones, appropriate procedures are performed. In neurogenic causes, management of the underlying condition and intermittent self-catheterization may be used. Antibiotics are reserved for concurrent infection.

Prognosis depends on cause and prompt treatment; chronic retention can lead to hydronephrosis and renal impairment, while timely relief often restores voiding function.