When You Can't Urinate After a Stroke


After a stroke, it can be very distressing if you lose control of urine. However, because urination is a particularly complex process involving coordination between the brain, the spine and the nerves, a stroke can also produce the opposite effect, which is the inability to urinate. This is called bladder retention and it means that you can't completely empty your bladder or that you can't go when you want to go.

Problems with Bladder Retention

The most obvious problem with bladder retention is that it is uncomfortable. When you can’t empty your bladder, you may feel a sensation of fullness and discomfort in the lower pelvic area. After a while, if you cannot empty your bladder when you what to, the buildup of urine can be so extreme, that urine may finally leak out on its own, causing embarrassment and wetness.

Sometimes, if the muscles that help you urinate are so weakened because of your stroke, the urine may remain in your bladder for so long that you can develop an infection. This kind of infection is called a UTI (urinary tract infection.) A UTI is an infection of the bladder or the ureters or the kidneys. If the infection involves the kidneys, this is usually much more serious. UTI’s can produce fevers, chills, bleeding in the urine and can even spread to cause an infection of the rest of the body.

UTI’s generally do not get better on their own and often require prescription strength antibiotic medication

Treatment for Bladder Retention

There are treatments for bladder retention. Most patients with bladder retention need physical therapy for bladder training. Some prescription medicines can help with bladder retention.

A number of medications can also produce bladder retention as a side effect, so your doctor may need to make some prescription changes if you experience bladder retention. Sometimes, your nurse or therapist might teach you how to place a catheter to drain the urine. While it may seem awkward, sometimes using a catheter is the most effective way to take care of bladder retention.

New methods of treating bladder retention include injection of botulinum toxin (popularly known as Botox.) Botulinum toxin has been used as a treatment for muscle stiffness after a stroke for years, and has been approved only recently for bladder problems. A recent study evaluated electro acupuncture as a possible therapy for bladder retention after a stroke and the results were promising.

Urine Problems After a Stroke

After a stroke, control of urination can be a major lifestyle and health problem. Some people lose control of urine and have to go urgently or frequently or may even wet their pants. Some people can't go when they want to because the urine won't start or won't completely empty. And many stroke patients experience a combination of both problems. Talk to your doctor about any problems you have with urination because there are serious complications if the problem goes untreated for too long.

But there are effective treatments for bladder control problems. You doctor has heard this problem before and there is nothing to be embarrassed about.


Characteristics of neurogenic voiding dysfunction in cerebellar stroke: a cross-sectional, retrospective video urodynamic study, Chou YC, Jiang YH, Harnod T, Kuo HC, Cerebellum, October 2013

Poststroke detrusor hyporeflexia in a patient with left medial pontine infarction, Wu MN, Guo YC, Lai CL, Shen JT, Liou LM, Neurologist, March 2012

Effects of electroacupuncture on recent stroke inpatients with incomplete bladder emptying: a preliminary study,Kuo-Wei Yu,Chien-Lin Lin,Chun-Chuang Hung,Eric Chieh-Lung Chou,Yueh-Ling Hsieh,Te-Mao Li, and Li-Wei Chou, Clinical Interventions in Aging, November 2012

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