As the seasons transition from summer to autumn, many people experience weakened immunity due to large daily temperature fluctuations. As a result, the number of people catching colds tends to increase. However, an important point that is often overlooked is that seasonal changes can also increase the risk of acute urinary retention, a condition in which urine suddenly cannot be passed at all.
The bladder, located in the lower abdomen, stores urine until the urge to urinate occurs and the bladder empties. In adults, the bladder can typically store approximately 400 to 500 milliliters of urine. In certain situations, however, a condition called acute urinary retention may occur. When acute urinary retention develops, a person may feel a strong urge to urinate but cannot pass urine.
There are several possible causes of acute urinary retention. As mentioned earlier, one cause can be the use of cold medications that contain antihistamines during seasonal illnesses. Another common trigger occurs when men who already have benign prostatic hyperplasia (BPH) consume excessive alcohol. In many unexpected situations, urine may suddenly stop flowing completely, creating an emergency condition that requires immediate catheterization in the emergency department.
In many cases, the underlying cause of acute urinary retention is benign prostatic hyperplasia. According to data from the Korean Urological Association, approximately 70% of male patients with acute urinary retention also have benign prostatic hyperplasia. As the prostate enlarges, it can compress the urethra and interfere with normal urination. Benign prostatic hyperplasia refers to the enlargement of prostate tissue that presses against the urethra and obstructs urine flow, leading to various urinary symptoms. When acute urinary retention occurs due to BPH, surgical treatment may be necessary.
A similar case occurred at Goldman Urology Clinic in Gangnam. A male patient in his 60s visited the clinic after experiencing complete urinary retention and requiring a urinary catheter. He had been receiving treatment at another hospital for more than 10 years, but his symptoms gradually worsened until acute urinary retention developed. A transrectal prostate ultrasound examination revealed that his prostate measured 61.4 grams. Considering that a normal prostate typically measures about 20 to 25 grams, his prostate had enlarged to approximately three to four times its normal size. A subsequent cystoscopic examination confirmed that the enlarged prostate had protruded into the bladder.
Based on these findings, surgical treatment was recommended. The patient underwent holmium laser enucleation of the prostate (HoLEP), which is known to provide excellent treatment outcomes and a low recurrence rate. Before surgery, his peak urinary flow rate was only 1.3 mL/sec. After surgery, the peak flow rate improved to 23.7 mL/sec, returning to a normal level. A peak flow rate above 20 mL/sec generally indicates strong and comfortable urination, demonstrating significant improvement in symptoms.
The patient was so satisfied with the surgical results that he even shared his experience on his personal Facebook page. For the surgeon who performed the procedure, this outcome was also extremely rewarding.
These cases highlight the importance of not ignoring symptoms of acute urinary retention. If acute urinary retention persists without proper treatment, the bladder muscles can gradually weaken, leading to declining bladder function. In addition, increased pressure in the bladder may cause hydronephrosis, which can impair kidney function over time.
Because acute urinary retention is a medical emergency, prompt treatment is essential. At our clinic, a fast-track treatment system allows patients to schedule an appointment and receive surgical treatment within one to two days if necessary. As emphasized earlier, when urinary symptoms become severe, it is important to identify and treat the underlying cause, such as benign prostatic hyperplasia.
As people enter middle age and beyond, urologic conditions become increasingly common. By providing helpful information about urinary diseases that interfere with everyday life, the goal is to support healthier and more comfortable daily living.