As the seasonal transition begins after the start of spring, concerns about maintaining health during this period tend to increase. Large fluctuations in daily temperature and dry weather conditions can weaken the immune system. During this time of year, cases of acute urinary retention—where urine suddenly cannot be passed at all—are also reported more frequently.
The bladder is located in the lower abdomen and functions as a reservoir for urine until the urge to urinate occurs. In adults, the bladder can typically hold approximately 400 to 500 milliliters of urine. However, when acute urinary retention occurs, patients experience a strong urge to urinate but are unable to pass urine. The lower abdomen may become distended and severe pain can develop, sometimes requiring emergency treatment with the insertion of a urinary catheter.
During seasonal changes, several factors can contribute to urinary retention. Changes in the autonomic nervous system, reduced physical resilience, and the use of cold medications may all play a role. In particular, antihistamines and certain ingredients found in cold medications can reduce bladder contractility while increasing urethral resistance, making urination more difficult. If excessive alcohol consumption is added to these factors, urinary function can deteriorate rapidly. Importantly, one of the most common underlying causes of acute urinary retention is benign prostatic hyperplasia (BPH).
According to data from the Korean Urological Association, approximately 70 percent of male patients with acute urinary retention also have benign prostatic hyperplasia. As the prostate enlarges, it compresses the urethra, which can weaken the urinary stream and create a persistent sensation of incomplete emptying. Over time, this obstruction may progress to the point where urination becomes completely blocked. For this reason, acute urinary retention is often considered a significant clinical signal that benign prostatic hyperplasia has progressed.
In the early stages of BPH, medication may help relieve symptoms. However, if medications are ineffective or if structural problems such as median lobe enlargement are present, surgical treatment may need to be considered. Modern treatment strategies for BPH increasingly focus not only on reducing prostate size but also on improving the bladder outlet more fundamentally. Common procedures include HoLEP (Holmium Laser Enucleation of the Prostate), Rezūm therapy, the iTind procedure, and Aquablation.
HoLEP surgery uses a holmium laser to separate and remove enlarged prostate tissue from its base. It is associated with a low recurrence rate and is often effective even in cases of large prostate volume or significant median lobe protrusion. Rezūm therapy is a minimally invasive treatment that uses high-temperature water vapor to cause targeted necrosis of enlarged prostate tissue and is performed through the urethra without surgical incisions. The iTind procedure involves temporarily inserting a device made of nitinol to expand the urethra and improve urinary flow.
Aquablation is a robotic waterjet-based technology that removes enlarged prostate tissue using a high-pressure stream of water. The treatment area is monitored in real time through ultrasound and endoscopic imaging, allowing precise tissue removal while minimizing thermal damage to surrounding structures.
An important point is that no single treatment approach is suitable for every patient. Treatment strategies should be individualized by considering several factors, including prostate size, the degree of intravesical protrusion, bladder function, patient age, and underlying medical conditions.
Dr. Ryu Kyungho of the Gangnam branch of Goldman Urology Clinic emphasized that acute urinary retention should not be regarded as a temporary condition. If left untreated, bladder muscle function may weaken and increased bladder pressure can lead to hydronephrosis, potentially worsening kidney function. He explained that the real issue is not simply the inability to urinate, but the underlying structural changes in the prostate and the decline in bladder function. Therefore, precise diagnosis is essential to determine the appropriate course of treatment.