Urine retention

Hello

Any ideas anyone, as the doctor I saw in A&E yesterday was flummoxed!

Staying at in-laws for the weekend, woke up yesterday morning, dying for a wee. Had to wait for a while because bathroom was in use. By the time I got in there, I couldn't actually pee even though I was bursting.

This has happened twice before to me, and both times I've ended up in hospital being catheterised. Same thing yesterday. A&E doctor said that it wasn't normal for a 33 yr-old fit, healthy woman to have urine retention. There was no infection in my urine when they finally got it out and tested it.

Apparently, they could hardly get the catheter in because the muscle was totally in spasm, which is presumably why I couldn't pee. Once they had emptied bladder and let me go home, I was OK again, and able to pee more or less normally for the rest of the day.

Last time it happened (5 years ago), I went to see urologist who told me there was nothing physically wrong with me, so it must be psychological.

Has this happened to anyone else?

I often find it quite difficult to get a 'flow going' if I've been holding on for too long. But very occasionally, it seems, the whole thing goes into spasm and that's it!

Of course, I had no end of 'taking the p1ss' jokes all day yesterday from husband and in-laws, so i don't need any more of those on here ;-)

I would ask to see a urologist again, just in case anything has changed, and also ask for a referral to the 'continence' nurse specialist (every health authority has one). They are the real experts, and very helpful.

Thanks, Sassie.
I guess the thing is that it happens so infrequently and there's no way I would be able to simulate it for the urologist if I went to see him!
The A&E doctor suggested trying to get a referral to a neurologist. Any idea why that would be?

sure he didn't say 'an urologist'? Sounds like 'a neurologist'.

No, definitely said neurologist...
After I'd said I'd already been to a urologist and he'd drawn a blank 5 years ago.
At least he didn't say psychologist (nothing against psychologists, btw!)

Caramel. I'm no expert, and can only comment on my own experiences. The psychological aspect cannot be ignored.

I have difficulty peeing in public places such as toilets with open urinals and generally cant do it 'on demand'.

There have been hundreds or thousands of times in my life where I was unable to have a wee even when I could hardly walk because I wanted a wee so badly.

...I remember one or two as a kid when my dad pulled over at the side of the road, and I felt pressured because he was trying to hurry me up. I think this must have carried through to adulthood.

I now have an issue with running races, and the associated toilet facilities. If they are not private I sometimes have a problem.

It could be stress or worry. Try and find something to think about which relaxes you, and take deep breaths, this helps to calm the nerves and dissipate any building adrenaline and stress hormones.

The other thing you should think about when you are trying to do it is that in my experience 75% of people have a similar problem. I only know a few people who can do it on demand anytime anywhere... now thats wierd in my book!

Dave

Thanks for that. I do know quite a few people who suffer in the same way as you, so I know that it's far from unusual. I don't know whether mine is the same thing, though, because I normally have NO problem peeing. I can pee at races when there's a huge queue; I can pee in the bushes surrounded by others at the GNR! I can normally pee fine - under pressure or not, cubical or al fresco, people battering down the door to get in or in solitude!

On the 3 occasions where the retention thing has happened to me, I've been away (1st time staying with a family in India, 2nd time travelling into the desert in Oman, 3rd time at in-laws in Newcastle - so it's obviously not the heat!!) and had to wait a while before I could use the loo. Normally, this isn't a problem for me, and I can still pee even if I have to wait (although sometimes takes me a while to 'get going' if I've waited for a long time). But on these 3 occasions, for whatever reason, I haven't been able to.

So, I guess it's possible that it might be something psychological to do with having to wait AND being somewhere where I don't have control (or think I don't have control) over when I go (in India, had to ask where toilet was, and we'd only just arrived at the house and were being subjected to tea and snacks etc. In Oman, travelling in jeep, had to interrupt journey to ask to go to the loo so delayed it as long as possible. At in-laws, someone in bathroom for an hour).

But I'd be interested to find out what the neurological thing might be...

I tried desperately to 'relax' and 'forget about it' yesterday morning, but it just didn't work. There was no way it was going to happen and I was in such agony, it was off to the A&E dept for me!

The nurse suggested a warm bath and trying to pee in the bath (yuck!) if it happens again. Problem is, it seems to happen where I don't even have control over the toilet availability, let alone peeing in someone else's bath!!

I think there are thousands of people in the same boat who don't like peeing in public places. I don't like being heard! Hope you get your answer Caramel.

Hi Caramel. At times like this I'd do a search on the internet if I were you. I bet you'll find loads of stuff about it.

And half the problem is just reading that there are thousands out there with the same problem as you... which makes the issue a smaller one.

For psycological issues there are often no explanations. Sometimes I can walk into a gents loo anywhere and do it no problem.

..once I even managed to give a sample as part of a health check, with a lady nurse the other side of the curtain... and this was something that I was really dreading.

all the best anyway.

Thanks all!

I've 'googled' it this morning and did find an article which talked about urinary retention in young-ish females with no other health problems, and it basically said 'it happens sometimes but we don't know why'.

A lot of the info on the web is about people who have had operations and then have the problem afterwards. Also diabetes and MS seem to cause the symptoms, but the A&E doc questioned and did some simple tests to rule those out yesterday.

I'd just like to know if there could possibly be a neurological (or any other form of 'ological) reason for my bladder muscle (or whatever it is called) sometimes going into spasm if I wait too long before I pee. And if there is a reason, what can I do to prevent it or to alleviate it once it happens other than having to go to A&E?

I guess I'll find the answer to a lot on these forums, but possibly not that question!

Caramel
i have not had this problem but have had a taste of this experience in a small way and am thinking how this can happen...

my 6 year old has a habit of saying he needs a wee, the minute i mention that i am popping for one - i guess it kind of reminds him to go

anyhow
sometimes he literally dives in the loo about a second before me when i am desperate and just closing the door - he thinks that is funny (!) -
and what i find is this...

if the muscle that is holding the wee in, has kind of begun to expect to be released, and then has to quickly tighten up again (when he dives in front of me) then ...when i finally get to go, after him, it takes a mo or two for the muscle to relax again

so i am wondering if yours is just a stronger version of that ie the muscle kind of locks up into spasm, if you are having to hold it too long , especially if it is momentarily released then re tightened

would that make sense?

eg when you were at your inlaws, you were expecting to go straight into the loo , only to then find it occupied

Caramel

My leg muscles went into spasm - so bad that I used to use a stick to walk after excercise...its been a life long problem...which I've now got rid of and it was 100% caused by stress


I sometimes had to wait ages to pee but always could and never thought anything of it until reading your post - just assumed everyone did sometimes!!!

Have you experienced any stress at all before these events happened ?

also googling
there is something called neurogenic bladder that might be why they mentioned a neurologist

this page explains what tests can be done to investigate this and what causes it

http://www.urologyhealth.org/adult/index.cfm?cat=03&topic=109

I guess you should follow up with neurologist if you are concerned about this happening again

Caramel,

if there's no infection, nothing physically wrong, etc, then it may well be "psychological", but that doesn't mean anything dramatic - - It doesn't mean to suggest you're doing it on purpose, or crazy or anything. Given what you said about the different circumstances each time it happened, though, it doesn't sound random. It probably is in some way triggered by a particular set of circumstances.

Where's Dr Plodding Hippo when you need her, eh?


I think if it's been 5 years between occurrences, it is extremely unlikely to be caused by nerve or muscle damage (as per neurogenic bladder). Stress (as Unicorn mentioned) or stress of a specific kind, sounds more likely.

here
er cant add anything
have seen this myself too

neurologist would indeed be sensible-as a precaution
but weeing is complex-and ultimately controlled by your brain
so yes-can indeed be psychological in origin

BTW
most of my patients do not pee and this isnt my specialty

thanks all!

yes - LOK, i staggered out of bed at about 5am expecting to be able to get into the bathroom only to find it locked. then had to go back to bed for an hour until it was available.

my husband thought it was HUGELY funny on sunday morning, until i made him get his mum up at 6.45am and drive me to A&E!
i guess it does sound more psychological than anything, particularly as it hasn't ever happened at home. but i'm going back to the doc tomorrow to see if i can get referred again to see someone.
i'm not diving to the loo every time i *think* i might need to go. not taking any chances!

it's funny how most things can be attributed to stress. i went to the dentist in the summer with an INCREDIBLY painful jaw, and that was stress as well, apparently.

what did we do before we had stress to blame everything on?!

that should of course have said 'i'm NOW diving to the loo'