Urinary retention: what it feels like, what causes it, and how to act

Can’t pass urine and feeling a tight, painful pressure in your lower belly? That’s urinary retention. It can show up suddenly and hurt a lot (acute retention), or slowly over weeks and months (chronic retention). Either way, it’s a problem you shouldn’t ignore.

Acute urinary retention is scary because you usually can’t pee at all. You may sweat, feel sick, or have a strong need to go but nothing comes out. Chronic retention feels different: you might pass small amounts of urine, go often at night, or feel like your bladder never fully empties.

Common causes to watch for

Think of urinary retention as either a blockage or a wiring problem. Blockage examples: an enlarged prostate in men, urethral strictures, bladder stones, or tumors that press on the urinary tract. Wiring problems come from nerve issues: diabetes, spinal cord injury, multiple sclerosis, or after certain surgeries. Some medicines also make retention worse—anticholinergics, certain antidepressants, strong pain meds, and some antihistamines.

Age and recent surgery raise the risk. Men over 50 are more likely because of prostate changes. Women can get retention after pelvic surgery or childbirth. If you’ve had constipation for a long time, that can press on your bladder and make things worse.

When to get help and what to expect

If you can’t urinate at all or you have severe lower belly pain, go to the nearest emergency room. They’ll usually scan your bladder and insert a catheter to drain it—fast relief. For less urgent but persistent symptoms, see a primary care doctor or urologist. Expect a bladder scan, urine test, and possibly a prostate exam or imaging.

Treatment depends on the cause. For blockage from an enlarged prostate, doctors may try alpha-blockers (like tamsulosin) or surgery if needed. If a medication is the cause, stopping or changing it often helps. Nerve-related retention may be managed with intermittent self-catheterization, medications that help bladder contractions, or physical therapy focused on pelvic health. Infections get antibiotics. Stones or strictures might need procedures to clear the blockage.

Practical steps you can use now: don’t hold urine for long periods, treat constipation, avoid strong antihistamines if you’ve had retention before, and keep a list of current meds to show your doctor. If you’re coping with chronic retention, learning clean intermittent catheterization can be life-changing and reduce infection risk.

Urinary retention is common but treatable. Sudden inability to pee needs urgent care; slower symptoms still deserve a checkup so you can avoid infections and long-term bladder damage. If you’re unsure whether to seek care, a quick call to a nurse line or your doctor is a good start.