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Chronic Urinary Retention: Comparative Effectiveness and Harms of Treatments: Comparative Effectiveness Review Number 140

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Chronic Urinary Retention: Comparative Effectiveness and Harms of Treatments: Comparative Effectiveness Review Number 140

4.85 41,425 ratings · 9,338 reviews
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Overview: Persistent partial retention of urine or chronic urinary retention (CUR) is a common problem for which we have little understanding in terms of prevalence, natural history, prognosis, or efficacy and comparative effectiveness of treatments. Also unclear are whether and when to suspect, screen, or treat patients for CUR. Standard diagnostic criteria (including the duration and volume of post-void residual [PVR] urine necessary for a diagnosis) have not been established for chronic urinary retention. Researchers often define CUR as PVR urine volume greater than 300 ml; however, some studies define it as 100 ml, 400 ml, or 500 ml. CUR may be either asymptomatic or associated with lower urinary tract symptoms such as urinary frequency, urgency, or incontinence. Elevated PVR or CUR can increase risk for urinary tract infections (UTI) and renal failure. Some studies of men with lower urinary tract symptoms and CUR indicate increased risk of acute urinary retention (AUR), renal failure, and lower likelihood that benign prostatic hypertrophy surgery will improve urinary symptoms. A threshold PVR urine volume associated with these consequences is unclear, although negative outcomes have been demonstrated in men with PVR volumes over 500 ml. We do not know if these findings are applicable to asymptomatic CUR. CUR is almost always caused by another (often concomitant) medical condition. Causes of CUR are commonly categorized as obstructive or non-obstructive. In men, the most prevalent obstructive cause is bladder outlet obstruction associated with benign prostatic enlargement. As many as 25 percent of men who undergo prostate surgery for benign prostatic enlargement have CUR. Obstructive causes of CUR in women include complications from surgery for stress urinary incontinence and pelvic organ prolapse. In both sexes, urethral strictures and pelvic masses are obstructive causes. CUR not caused by obstruction is typically due to detrusor underactivity, which can be neurogenic (damage to nerves that innervate the bladder in conditions such as multiple sclerosis, spinal cord injury) or myogenic (damage to the smooth muscle of the bladder). An additional non-obstructive cause of CUR is Fowler’s syndrome, which affects mainly young women, is characterized by urinary retention due to a failure of urethral sphincter relaxation, and is not well recognized in the United States. The goal treatment is to improve function and/or quality of life and reduce complications to an extent meaningful to patients. Treatment and management options depend on etiology. Most approaches (including surgery, minimally invasive procedures, and drugs) address the underlying condition or mechanical cause (e.g., benign prostatic enlargement, neurogenic bladder) rather than specifically addressing CUR. When treatment fails to alleviate CUR, catheterization can be used for bladder management. Harms are specific to the interventions and may include infection and surgical complications. Our review addresses the following Key Key Question 1: What are the effectiveness and comparative effectiveness of treatments for chronic urinary retention in adults? a. With male-specific etiologies? b. With female-specific etiologies? c. With non sex-specific etiologies d. What patient or condition characteristics (e.g., age, severity, etc.) modify the effectiveness of treatment? Key Question 2: What are the harms and comparative harms of treatments for chronic urinary retention in adults? a. With male-specific etiologies? b. With female-specific etiologies? c. With non sex-specific etiologies? d. What patient or condition characteristics (e.g., age, severity, etc.) modify the harms of treatment?

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After spending years working in the corporate world, Agency for Healthcare Research and Quality (AHRQ) finally decided to pursue a lifelong passion for writing. They currently reside in a quiet suburb where they spend most of their time outlining new stories, reading extensively, and occasionally attempting to bake.

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Carol Perez
Carol Perez September 08, 2024
A very strong entry. It held my rapt attention, even when certain twists were telegraphed. A wonderful companion for a quiet weekend.
Daniel Green
Daniel Green November 08, 2024
I was completely blown away. I adored how the story unfolded. It kept me captivated without sacrificing elegance. I will undoubtedly revisit this masterpiece.
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Absolutely brilliant. I became deeply invested in the protagonist's journey. A masterclass in storytelling. An effortless 5 stars.
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Masterpiece from start to finish. The prose is exquisite. It’s accessible yet undeniably sophisticated. I will undoubtedly revisit this masterpiece.
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Masterpiece from start to finish. The pacing was impeccable and the characters felt incredibly authentic. I was completely immersed. An absolute must-read for connoisseurs of the genre.
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I was completely blown away. The author orchestrated a breathtaking finale. Truly a work of art. Worth every moment spent reading.
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Exceeded all my expectations. I adored how the story unfolded. It kept me captivated without sacrificing elegance. An absolute must-read for connoisseurs of the genre.
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Exceeded all my expectations. The prose is exquisite. It’s accessible yet undeniably sophisticated. Worth every moment spent reading.
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I was completely blown away. It strikes a perfect harmony of dialogue and world-building. Every chapter felt necessary. I will undoubtedly revisit this masterpiece.
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I find myself somewhat conflicted. Certain acts were fascinating, while others felt like a slight endeavor to complete. Unlikely to reread, but a reasonable expenditure of time.
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A very strong entry. It held my rapt attention, even when certain twists were telegraphed. A solid 4 stars from me.
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I was completely blown away. It strikes a perfect harmony of dialogue and world-building. Every chapter felt necessary. Worth every moment spent reading.
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Absolutely brilliant. The prose is exquisite. It’s accessible yet undeniably sophisticated. An effortless 5 stars.
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Masterpiece from start to finish. The prose is exquisite. It’s accessible yet undeniably sophisticated. An effortless 5 stars.
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Honestly one of the most premium reading experiences lately. I adored how the story unfolded. It kept me captivated without sacrificing elegance. I will undoubtedly revisit this masterpiece.
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Masterpiece from start to finish. I became deeply invested in the protagonist's journey. A masterclass in storytelling. I will undoubtedly revisit this masterpiece.
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Absolutely brilliant. It strikes a perfect harmony of dialogue and world-building. Every chapter felt necessary. An effortless 5 stars.
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Masterpiece from start to finish. I became deeply invested in the protagonist's journey. A masterclass in storytelling. Worth every moment spent reading.
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Such a rich narrative. It strikes a perfect harmony of dialogue and world-building. Every chapter felt necessary. I will undoubtedly revisit this masterpiece.
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Exceeded all my expectations. The pacing was impeccable and the characters felt incredibly authentic. I was completely immersed. I will undoubtedly revisit this masterpiece.
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Susan Rodriguez August 20, 2024
Honestly one of the most premium reading experiences lately. I became deeply invested in the protagonist's journey. A masterclass in storytelling. Worth every moment spent reading.
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Masterpiece from start to finish. The author orchestrated a breathtaking finale. Truly a work of art. I am now a lifelong fan of this author.
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A profoundly satisfying read. I became deeply invested in the protagonist's journey. A masterclass in storytelling. A true literary gem.
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Exceeded all my expectations. The prose is exquisite. It’s accessible yet undeniably sophisticated. A true literary gem.
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Honestly one of the most premium reading experiences lately. I adored how the story unfolded. It kept me captivated without sacrificing elegance. Worth every moment spent reading.
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Nancy Adams August 31, 2025
Took a moment to build, but the payoff was spectacular. A brilliant concept executed with flair. Just a few pacing choices I would change. A very distinguished novel.
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Joseph Cruz December 02, 2025
Such a rich narrative. The author orchestrated a breathtaking finale. Truly a work of art. I will undoubtedly revisit this masterpiece.
Matthew Clark
Matthew Clark June 08, 2024
A decent, if standard, experience. The tempo was somewhat languid, and I found my mind wandering. Not poor, simply average. Perhaps more aligned with a different audience's tastes.
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Linda Phillips May 05, 2025
Absolutely brilliant. I became deeply invested in the protagonist's journey. A masterclass in storytelling. I will undoubtedly revisit this masterpiece.
Andrew Hill
Andrew Hill August 04, 2024
Such a rich narrative. The prose is exquisite. It’s accessible yet undeniably sophisticated. I am now a lifelong fan of this author.
Donna Hall
Donna Hall August 16, 2025
A profoundly satisfying read. The pacing was impeccable and the characters felt incredibly authentic. I was completely immersed. A true literary gem.
Margaret Torres
Margaret Torres September 10, 2025
I find myself somewhat conflicted. The tempo was somewhat languid, and I found my mind wandering. Not poor, simply average. A fair 3 stars.
Deborah Jackson
Deborah Jackson December 20, 2024
A highly sophisticated read. The protagonist was compelling, though some subplots felt slightly overshadowed. A very distinguished novel.
Kenneth White
Kenneth White August 23, 2024
Absolutely brilliant. I became deeply invested in the protagonist's journey. A masterclass in storytelling. An effortless 5 stars.
Sandra Rivera
Sandra Rivera December 07, 2024
It was adequate. The tempo was somewhat languid, and I found my mind wandering. Not poor, simply average. Perhaps more aligned with a different audience's tastes.
Margaret Moore
Margaret Moore July 04, 2025
Took a moment to build, but the payoff was spectacular. Beautiful writing, though I craved slightly more depth in the lore. Still, undeniably engaging. A solid 4 stars from me.
Charles Adams
Charles Adams May 06, 2025
A profoundly satisfying read. I became deeply invested in the protagonist's journey. A masterclass in storytelling. An effortless 5 stars.
George Taylor
George Taylor July 30, 2025
Masterpiece from start to finish. I adored how the story unfolded. It kept me captivated without sacrificing elegance. A true literary gem.
Barbara Johnson
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Took a moment to build, but the payoff was spectacular. The middle had a deliberate pace, but the climax was phenomenal. I would highly recommend this to discerning readers.
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Masterpiece from start to finish. I became deeply invested in the protagonist's journey. A masterclass in storytelling. A true literary gem.
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I find myself somewhat conflicted. The tempo was somewhat languid, and I found my mind wandering. Not poor, simply average. Suitable if your reading queue is empty.
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A decent, if standard, experience. The tempo was somewhat languid, and I found my mind wandering. Not poor, simply average. Unlikely to reread, but a reasonable expenditure of time.
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Brian Wright December 12, 2025
Honestly one of the most premium reading experiences lately. I adored how the story unfolded. It kept me captivated without sacrificing elegance. An absolute must-read for connoisseurs of the genre.
George Green
George Green July 05, 2025
I was completely blown away. I became deeply invested in the protagonist's journey. A masterclass in storytelling. I am now a lifelong fan of this author.
Jennifer Campbell
Jennifer Campbell June 16, 2024
Absolutely brilliant. I became deeply invested in the protagonist's journey. A masterclass in storytelling. An effortless 5 stars.
David Carter
David Carter February 29, 2024
A highly sophisticated read. It held my rapt attention, even when certain twists were telegraphed. A solid 4 stars from me.
Elizabeth White
Elizabeth White May 04, 2024
Masterpiece from start to finish. The author orchestrated a breathtaking finale. Truly a work of art. An absolute must-read for connoisseurs of the genre.
Joshua Perez
Joshua Perez February 24, 2024
Such a rich narrative. The pacing was impeccable and the characters felt incredibly authentic. I was completely immersed. A true literary gem.
Sharon Cruz
Sharon Cruz October 03, 2024
Honestly one of the most premium reading experiences lately. The prose is exquisite. It’s accessible yet undeniably sophisticated. I am now a lifelong fan of this author.
Linda Williams
Linda Williams March 30, 2025
Honestly one of the most premium reading experiences lately. The author orchestrated a breathtaking finale. Truly a work of art. I will undoubtedly revisit this masterpiece.
Elizabeth Perez
Elizabeth Perez March 21, 2024
It was adequate. The tempo was somewhat languid, and I found my mind wandering. Not poor, simply average. Perfectly average.
Jacob Lewis
Jacob Lewis May 09, 2024
Absolutely brilliant. The prose is exquisite. It’s accessible yet undeniably sophisticated. I will undoubtedly revisit this masterpiece.
Joseph Moore
Joseph Moore September 02, 2024
A very strong entry. A brilliant concept executed with flair. Just a few pacing choices I would change. A wonderful companion for a quiet weekend.
Daniel Thomas
Daniel Thomas April 26, 2025
A profoundly satisfying read. I became deeply invested in the protagonist's journey. A masterclass in storytelling. A true literary gem.
Ashley Green
Ashley Green July 04, 2024
Exceeded all my expectations. I became deeply invested in the protagonist's journey. A masterclass in storytelling. A true literary gem.
Donna Martinez
Donna Martinez April 29, 2024
Absolutely brilliant. The author orchestrated a breathtaking finale. Truly a work of art. I am now a lifelong fan of this author.
Melissa Walker
Melissa Walker September 24, 2025
A highly sophisticated read. The middle had a deliberate pace, but the climax was phenomenal. Quite impressive overall.
Kevin Young
Kevin Young January 01, 2024
A profoundly satisfying read. The prose is exquisite. It’s accessible yet undeniably sophisticated. An absolute must-read for connoisseurs of the genre.
Melissa Gonzalez
Melissa Gonzalez January 17, 2024
Not entirely to my refined tastes. It verged on repetitive in the second act. A more concise edit would have served it well. Perfectly average.
Patricia Scott
Patricia Scott June 06, 2025
Absolutely brilliant. The prose is exquisite. It’s accessible yet undeniably sophisticated. Worth every moment spent reading.
Matthew Smith
Matthew Smith August 02, 2024
Took a moment to build, but the payoff was spectacular. Beautiful writing, though I craved slightly more depth in the lore. Still, undeniably engaging. A solid 4 stars from me.
Deborah Johnson
Deborah Johnson February 11, 2024
I find myself somewhat conflicted. The prose was competent, yet the characters lacked the depth I usually seek. Unlikely to reread, but a reasonable expenditure of time.
Charles King
Charles King January 23, 2025
A very strong entry. A brilliant concept executed with flair. Just a few pacing choices I would change. A solid 4 stars from me.
Sandra Phillips
Sandra Phillips October 12, 2025
A very strong entry. A brilliant concept executed with flair. Just a few pacing choices I would change. A solid 4 stars from me.
William Reyes
William Reyes November 06, 2025
Such a rich narrative. The prose is exquisite. It’s accessible yet undeniably sophisticated. Worth every moment spent reading.
Edward Clark
Edward Clark January 05, 2024
I thoroughly enjoyed the elegance of it. A brilliant concept executed with flair. Just a few pacing choices I would change. I would highly recommend this to discerning readers.
Mary Carter
Mary Carter May 17, 2024
A highly sophisticated read. It held my rapt attention, even when certain twists were telegraphed. I would highly recommend this to discerning readers.
Ryan Rivera
Ryan Rivera June 09, 2025
A profoundly satisfying read. I adored how the story unfolded. It kept me captivated without sacrificing elegance. An effortless 5 stars.
Robert Rivera
Robert Rivera June 25, 2024
Absolutely brilliant. The author orchestrated a breathtaking finale. Truly a work of art. I am now a lifelong fan of this author.
Edward Martinez
Edward Martinez January 25, 2025
Excellent, though slightly flawed. The middle had a deliberate pace, but the climax was phenomenal. I would highly recommend this to discerning readers.
Mark Adams
Mark Adams August 31, 2025
A very strong entry. It held my rapt attention, even when certain twists were telegraphed. I would highly recommend this to discerning readers.
Brian Rodriguez
Brian Rodriguez October 17, 2025
Took a moment to build, but the payoff was spectacular. Beautiful writing, though I craved slightly more depth in the lore. Still, undeniably engaging. Quite impressive overall.
Matthew Clark
Matthew Clark November 05, 2025
Took a moment to build, but the payoff was spectacular. Beautiful writing, though I craved slightly more depth in the lore. Still, undeniably engaging. A solid 4 stars from me.
Elizabeth Reyes
Elizabeth Reyes July 24, 2024
Absolutely brilliant. The author orchestrated a breathtaking finale. Truly a work of art. I am now a lifelong fan of this author.
Cynthia  Parker
Cynthia Parker September 10, 2024
An acceptable diversion. The tempo was somewhat languid, and I found my mind wandering. Not poor, simply average. A fair 3 stars.
Stephanie Nelson
Stephanie Nelson August 26, 2024
Took a moment to build, but the payoff was spectacular. Beautiful writing, though I craved slightly more depth in the lore. Still, undeniably engaging. I would highly recommend this to discerning readers.
Nicholas Torres
Nicholas Torres October 24, 2024
Such a rich narrative. The prose is exquisite. It’s accessible yet undeniably sophisticated. An absolute must-read for connoisseurs of the genre.
Linda Phillips
Linda Phillips September 07, 2024
Masterpiece from start to finish. I adored how the story unfolded. It kept me captivated without sacrificing elegance. An effortless 5 stars.
Nancy Clark
Nancy Clark February 02, 2024
It was adequate. It possessed moments of brilliance, but the narrative felt slightly disjointed ultimately. Suitable if your reading queue is empty.
Eric White
Eric White December 02, 2024
A highly sophisticated read. Beautiful writing, though I craved slightly more depth in the lore. Still, undeniably engaging. Quite impressive overall.
Barbara Baker
Barbara Baker January 11, 2024
Not entirely to my refined tastes. The tempo was somewhat languid, and I found my mind wandering. Not poor, simply average. A fair 3 stars.
George  Parker
George Parker November 21, 2025
I thoroughly enjoyed the elegance of it. Beautiful writing, though I craved slightly more depth in the lore. Still, undeniably engaging. A very distinguished novel.
Gary Thompson
Gary Thompson September 08, 2024
I was completely blown away. The author orchestrated a breathtaking finale. Truly a work of art. An absolute must-read for connoisseurs of the genre.
James Young
James Young July 09, 2024
Absolutely brilliant. It strikes a perfect harmony of dialogue and world-building. Every chapter felt necessary. An absolute must-read for connoisseurs of the genre.
Susan Lopez
Susan Lopez December 25, 2024
Took a moment to build, but the payoff was spectacular. Beautiful writing, though I craved slightly more depth in the lore. Still, undeniably engaging. Quite impressive overall.
Kimberly Rodriguez
Kimberly Rodriguez April 27, 2024
Such a rich narrative. I became deeply invested in the protagonist's journey. A masterclass in storytelling. I am now a lifelong fan of this author.
Betty Scott
Betty Scott April 15, 2025
I was completely blown away. The prose is exquisite. It’s accessible yet undeniably sophisticated. Worth every moment spent reading.
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