Inability to Urinate

Reviewed by: HU Medical Review Board | Last review date: September 2017.

Some patients who are diagnosed with bladder cancer have the symptom of being unable to urinate.1 The most common symptom of bladder cancer is blood in the urine that is easily visible. Between 80% and 90% of patients diagnosed with bladder cancer experience this symptom, and for many patients it is the only symptom.

Problems with urination

Some patients experience other symptoms related to problems or changes in urination, such as:

How does bladder cancer impact the bladder lining?

Bladder cancer usually starts growing in the thin layer of cells that line the inside of the bladder. The cancer cells can gather together to form tumors in the bladder lining. In non-muscle-invasive bladder cancer, the tumors are only located in the bladder lining.

In muscle-invasive bladder cancer, the cancer is more advanced and the tumors may have grown deeper into the muscles of the bladder wall. If the bladder cancer has metastasized, it means that the cancer cells have spread to other parts of the body beyond the bladder. The symptom of being unable to urinate is more common among patients who have more advanced bladder cancer than in patients with early stage bladder cancer.

What is urinary retention?

Urinary retention is the medical term for the symptom of being unable to urinate.2 This happens when a person is unable to empty the bladder completely, or unable to urinate at all. This symptom can affect both men and women, and patients can experience it in different ways. Some patients have trouble starting the flow of urine, despite feeling the urge to urinate, and other patients have a weak flow of urine once they start urinating. Other patients may leak urine when they are not urinating, and others feel the need to urinate again right after going.

Talk to a doctor as soon as possible

If you are suddenly unable to urinate at all when you have a full bladder, let your healthcare provider know right away. It is also important to let your healthcare provider know you experience any of the symptoms described above, especially if you have also noticed any blood in your urine. The symptom of being unable to urinate is usually caused by something other than bladder cancer, but if bladder cancer is the cause, then it is important to find out as soon as possible so you can begin treatment.

Examining the bladder through a cystoscopy

If you experience the symptom of being unable to urinate, your healthcare provider will perform a physical examination and will usually need to use an examination called a cystoscopy to find out more about what is causing the symptom. During a cystoscopy, a very thin tube with a very tiny camera is inserted into the urethra, which is the tube in the body that carries urine from the bladder out of the body during urination. The camera allows a healthcare provider to examine the inside of the urethra and the lining of the bladder in order to find out what may be causing the symptom.

What else can cause an inability to urinate?

In some cases, bladder cancer can cause the symptom of being unable to urinate.2 However, there are other conditions that more commonly cause the symptom. In many patients, the cause is something that is preventing urine from flowing from the bladder and through the urethra. This can be caused by taking certain types of medications, or it can be caused by bladder stones.

Both men and women can develop a condition called a stricture, which is a narrowing of the urethra that makes it difficult for urine to flow through it. The symptom can also be caused by a problem in the nerves that connect the bladder to the brain to control urination.

In men, a common cause of being unable to urinate is a problem with the prostate gland, which is located next to the bladder. The prostate can become enlarged and press on the urethra, which can block the flow or urine or prevent it from flowing freely.

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