Session nine:
Care of patient with retention of
urine
Learning Tasks
At the end of this session a learner is expected to
be able to:
• Define retention of urine
• Explain causes of retention of urine
• Outline signs and symptoms of retention of
urine
• Describe the nursing measures of patient with
retention of urine
• Outline the complication of retention of urine
Definition of retention of urine
• Retention of urine refer to the inability to
pass urine from the bladder despite the
desire to do so.
• Urine is normally produced by the kidneys
but cannot be excreted from the bladder
Causes of retention of urine
 Strong emotions, especially excitement, fear or
embarrassment.
 Obstruction, such as enlargement of the
prostate gland, tumour in the bladder or
urethra, calculi, urethral stricture and swelling
at the urethral meatus following childbirth.
 Following abdominal, pelvic or anal
operations.
Causes cont…
Injury to sensory or motor nerves involved
in the act of micturition, such as in spinal
cord injury.
Neurogenic bladder dysfunction
Certain drugs, such as atropine and some
antidepressants
Signs and symptoms of retention of urine
o Absence of voiding within 8 to 10 – hours
period during which the patient has had normal
fluid intake.
o Distended bladder above the symphysis pubis
which can be palpated.
o The patient may have constant desire to urinate
but efforts to pass the urine are unsuccessful.
o The patient will be uncomfortable, restless and
may sweat profusely. He may experience
severe pain in the pelvic area.
Nursing measures
retention of urine
of
patient
with
• Providing privacy for the patient and helping him to
relax
• Assisting the patient to assume a position as close to
a normal voiding position as possible. For example,
helping him to sit upright in bed or stand at bedside
while using urinal.
• A female patient may be helped to sit on a commode
if permitted.
• Giving the female patient a wormed bedpan. The
bedpan can be warmed by rinsing it in hot water.
Nursing measures cont…
• Providing local warmth to suprapubic region,
such as hot – water bottle or a warm pad.
• Offering the patient hot drinks, such as tea,
coffee or milk.
• If the patient is fit allow him to have a warm
bathe.
• Placing the patient’s hot drinks, hands in warm
water.
Nursing measures cont…
• Providing for the sound of running tap water
near the patient
• Offering psychological reassurance and
support.
• Administering prescribed analgesics postoperative patients as the retention may be due
to pain in the operation site.
• If the above nursing measures fail to effect
micturition, you need to catheterize the bladder
under strict surgical asepsis.
Complication of patient with retention of
urine
Inflammation of the bladder (cystitis). The
stagnation of the bladder provides a good
medium for bacteria to grow and multiply.
Back pressure is created on the ureters and
reflux of urine may impair the proper
functioning of the kidneys.
Complications cont…
Loss of tone of the muscles of the bladder
wall.
Kidney damage
Bladder damage
Urinary tract infection
Key Points
• Retention of urine refer to the inability to
pass urine from the bladder despite the
desire to do so. Urine is normally produced
by the kidneys but cannot be excreted from
the bladder.
Evaluation
• What is retention of urine
• What are the causes of retention of urine
• What are the complications of retention of
urine