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Emergency Department Discharge Instructions

Urinary retention

Emergency Care Discharge Instructions

Instruction summary

Urinary retention is an inability to pee, despite trying. It is common in older men who have an enlarged prostate (e.g. benign prostatic hypertrophy, also known as BPH). 

The prostate is a small gland that wraps around the urethra, the tube that leads from the bladder to the outside world. In men with large prostates, the prostate can narrow the urethra, making it difficult to pee (i.e. the stream is weak and/or many attempts need to be made to empty the bladder). The urethra can also be squeezed shut when a urinary tract infection causes inflammation and swelling of the tissues in the area. The combination of a urinary tract infection and an enlarged prostate may lead to complete urinary retention.

If you were completely unable to pee, you likely had a catheter inserted into the bladder in the ER. In general, the catheter stays in for 1-2 weeks. If the catheter is taken out early, the urethra will likely close again, you will be again unable to pee, and you will need to return to the ER to have another catheter inserted. Removing the catheter without deflating the balloon first can lead to significant damage to the tissues – never attempt to remove it yourself. Instead, see your family doctor or urologist in 1-2 weeks to have the catheter removed.

Tips for taking care of a leg bag from a urinary catheter
  • When you are attaching the bag to the catheter, keep it slack, not tight (allow extra tube length between the bag around the ankle and the tip of the penis). If the tube has no slack it can cause pain.
  • Make sure that the tube connecting to the bag is firmly closed. If this is loose, bacteria can travel back up the tube into your bladder.
  • The bag is attached to white elastic bands with many small slits and a button. To fasten the bag to your leg, wrap the elastic bands around your leg and push the button into one of the slits in the elastic band to hold it in place. Do this for both the top and bottom elastics.
  • To drain the bag: Take the bag off of your leg (open the elastics that encircle your lower leg) and hold the bag over the toilet. Next open the valve that is at the bottom of the bag, which twists open and allows the urine to escape. Or you can leave the bag on the leg, if that is more comfortable. After the urine has drained, remember to close the valve and wipe it with an alcohol swab.
Reasons to return to the ER
  1. Blockage of the catheter (no urine entering the bag after you have drained it)
  2. Leakage of urine or blood around the catheter or the tip of the penis
  3. Fever (≥38.0 °C or 100.4 °F)
  4. New upper back pain (located around the bottom of the ribs)
  5. If the catheter falls out