What to Know About Postop Urinary Retention

It’s not uncommon to have trouble urinating after surgery. While most cases of postoperative urinary retention resolve on their own, you may need to temporarily use a catheter or take medication to help your bladder drain.

Postoperative urinary retention (POUR) refers to difficulty urinating after surgery even though your bladder is full. It’s relatively common and can often happen due to factors like anesthesia, medications, or the procedure physically affecting the urinary system.

Symptoms of urinary retention can include:

• difficulty peeing or inability to pee
• bladder pain or discomfort
• bladder spasms
• abdominal swelling

It’s important to note that many people with urinary retention don’t experience any symptoms.

Experts generally recommend that no one go without peeing for more than 6 to 7 hours. If you can’t pee after 7 hours, it’s considered a medical emergency, and you should seek immediate care.

The issue is very treatable and usually gets better within a few weeks. Often, it resolves on its own. Here’s what to else know about POUR.

Various muscles, nerves, and your brain and spinal cord coordinate to help you pee. Sometimes, surgery can impact this system and temporarily disrupt it.

POUR can be caused by several factors, including:

• Anesthesia: Anesthetics that numb or paralyze muscles or nerves can cause you not to feel the “signals” that your bladder is full.
• Inflammation or obstructions: Surgeries of the abdomen, pelvis, or any part of the urinary tract system or surrounding organs, tissues, or nerves can cause inflammation that may make urinating difficult. Spinal cord surgeries can also cause problems with the nerves that control urination. Those who undergo knee, hip, or colon surgery also have a higher chance of experiencing urinary retention.
• Medication: Pain medications, especially stronger ones like opioids or in higher doses, can cause urinary retention issues. Like with anesthesia, they can numb the region. They can also cause constipation, which can put pressure on your urethra and make it harder to pee.

Reported rates of POUR range from 5% to 70% . That’s a pretty wide range, partly because rates of POUR vary across different procedures. Plus, certain factors can impact your chances of experiencing POUR.

• Age: Older adults have a higher risk of postop urinary retention.
• Sex: Males have an increased risk compared to females.
• Other conditions:Diabetes, renal failure, benign prostate hyperplasia, and mental health conditions like depression can increase your risk.

Your surgeon can help you better understand your risk based on the type of procedure and any risk factors.

POUR usually goes away on its own within 4 to 6 weeks. In some cases, it might resolve much sooner or a bit later.

If it doesn’t go away after a month or so or starts to limit your quality of life, follow up with your care team.

In the case of a full bladder for more than 7 hours or extreme pain in the bladder area, seek immediate care.

There are a few ways to manage postop urinary retention:

Catheterization

If your bladder is full and you can’t pee postsurgery, your doctor may recommend a urinary catheter.

Some people only require short-term catheterization during their stay in a medical facility, while others may need to keep it in at home until the issue resolves.

Alpha-blockers

Your clinician might also recommend alpha-blockers, a type of medication that relaxes your urethra, making it easier for your bladder to release and empty. These are sometimes used in combination with catheterization.

Hot therapy

Some people find that taking a warm bath or applying a warm compress to their abdomen helps with mild urinary retention.

It’s pretty common to have difficulty peeing after surgery. Most of the time, the issue will resolve on its own within a few weeks. But if you can’t pee at all within 7 hours of having surgery, seek immediate medical care.

If your symptoms don’t improve after several weeks or they start to interfere with your daily life, contact your surgeon. They may recommend catheterization or alpha-blockers to help drain your bladder.

Last medically reviewed on March 28, 2023