Can’t pee after surgery? That’s postoperative urinary retention, or POUR. It happens when your bladder fills but you can’t empty it. It’s common after many operations and can be painful, but knowing the signs and simple fixes helps you avoid complications.
POUR is usually noticed when someone hasn’t urinated within 6–8 hours after surgery or a bladder scan shows a large volume—often over about 400–600 mL. You may feel lower belly pain, a strong urge to go with little output, or a full, hard belly above the pubic bone.
Certain things raise the risk. Older age, being male, and having prostate enlargement (BPH) matter. Spinal or epidural anesthesia, long operating times, lots of IV fluids, and strong pain medicines—especially opioids—also increase risk. Some surgeries, like pelvic, hernia, or joint replacements, tend to cause POUR more often.
Even anxiety, being unable to relax in a hospital bathroom, or lying flat can stop normal voiding. Knowing these risks helps you and your care team act faster.
First, your team will try a bladder scan. It’s quick, painless, and shows how much urine is inside. If the bladder is very full or you can’t void, catheterization is the common fix. Intermittent catheterization (short-term insertion to drain and remove) is preferred when possible. It lowers infection risk compared with leaving a catheter in long-term.
If catheterization is needed for longer, an indwelling catheter may be used for a few days while the problem resolves. Some patients benefit from medications. In men with prostate issues, alpha-blockers like tamsulosin can make it easier to urinate. Drugs that force the bladder to contract, such as bethanechol, have limited and mixed evidence and are not commonly the first choice.
After treatment, your team will monitor urine output and look for signs of infection or bladder injury. If the bladder stays overdistended for too long, it can weaken the bladder muscle, so fast action matters.
Simple prevention steps help a lot: limit unnecessary IV fluids, remove urinary catheters as soon as safe, encourage walking soon after surgery, avoid heavy opioids when possible, and give the patient privacy and time to try voiding. Small tricks often work—warm water over the vulva or running water sounds can trigger the urge.
Call your provider right away if you have severe lower belly pain, can’t urinate for several hours, notice little or no urine output, or develop fever or shaking chills. Those could be signs of POUR complications or infection and need prompt care.
POUR is uncomfortable but usually treatable when recognized early. Talk with your surgical team about your personal risk and what they’ll do to prevent it before and after your operation.
I recently came across an interesting solution for postoperative urinary retention, called Bethanechol. This medication works by stimulating the bladder muscles, which helps in emptying the bladder after surgery. Many patients who undergo surgery face difficulties in urinating, but this drug seems to be highly effective in overcoming that issue. It's essential to consult a doctor before using Bethanechol, as it may not be suitable for everyone. Overall, it appears to be a promising solution for those dealing with postoperative urinary retention.
Callum Laird | Apr, 28 2023 Read More