What is urinary retention? Symptoms, causes, and how to get relief

Your bladder is full. You know it, you feel it — and yet, you can’t seem to fully empty it. Maybe it’s tough to get your urine stream started, and when it does start, it’s slow and weak. Or you still feel the need to pee again right after you go to the bathroom.

This is urinary retention: a condition in which you are unable to fully empty your bladder. It can be uncomfortable, and in some cases (if you cannot urinate at all) it may require prompt medical attention. For many people, urinary retention can be related to pelvic floor issues and lifestyle habits. There are simple things you can do at home, like gentle stretches and lifestyle changes, to help improve symptoms.

Here, learn more about what causes urinary retention, plus practical strategies to manage and treat it — including exercise tips from Hinge Health physical therapists.

What is urinary retention?

Urinary retention is when you are unable to empty your bladder completely — or in some cases, empty your bladder at all. There are two types of urinary retention: 

• Chronic urinary retention symptoms develop over time. You may have difficulty starting to urinate, or trouble keeping your stream going until your bladder is empty. 

• Acute urinary retention often comes on suddenly and can be severe. People with acute urinary retention are unable to urinate at all, even though they have a full bladder. This is a medical emergency and requires immediate care. This is much more common in people with male anatomy, and the risk increases with age.

If urine stays in your bladder too long or your bladder is not fully emptied — a situation sometimes called urinary stasis — it can increase your risk for urinary tract infections, bladder damage, kidney damage, and other complications. 

Urinary retention is different from other common bladder issues:

• Urinary hesitancy is when you have trouble starting to urinate or keeping your urine stream going once you begin.

• Urinary incontinence is when you involuntarily leak urine. 

• Urinary urgency is a sudden, strong need to urinate.

• Urinary frequency means urinating more often than usual.

If you have urinary retention, you may experience one or more of these symptoms alongside incomplete bladder emptying, especially when chronic urinary retention is due to nerve or muscle issues, or when urinary retention is complicated by overactivity or other bladder problems.

Causes of urinary retention

Urinary retention can happen for many reasons, including problems with your pelvic floor muscles, urethra, nerves, urinary tract, constipation, or certain medications. Below are common causes: 

• Tight pelvic floor muscles. Pelvic floor muscles help control urination. Your pelvic floor muscles must fully relax for the bladder muscle to contract and allow urine to flow out, explains Holly Tipp, PT, DPT, a Hinge Health physical therapist. If pelvic floor muscles are tense, weak, or uncoordinated, they can interfere with urine flow and bladder function.

• Urethra or bladder issues. The urethra is the thin tube that carries urine from the bladder out of the body. If the urethra or bladder neck (the area at the bottom of your bladder where it connects to the urethra) is blocked or narrowed, it can slow the flow of urine or make it more difficult to urinate. Scar tissue can form in the urethra following injury, surgery, or infections (such as sexually transmitted infections), causing it to narrow (urethral stricture). Kidney or urinary tract stones, blood clots, or other growths can also block urine flow. If the blockage is severe, you may not be able to urinate at all.

• Neurological issues. Conditions that affect the nerves — like diabetes, stroke, multiple sclerosis, or spinal cord injuries — can disrupt the signals between your brain, bladder, and pelvic floor, leading to urinary retention.  Urinary tract infections (UTIs). Infections can cause swelling and inflammation in the urinary tract or weakness in your bladder, which can contribute to urinary retention.

• Certain medications. Some medications — including opioid pain relievers, antihistamines, decongestants, and certain antidepressants — can interfere with bladder function and lead to incomplete bladder emptying.  

• Constipation. When stool backs up in the rectum, it can also sometimes place pressure on the bladder or urethra, making it harder to urinate.

Urinary retention can have different causes depending on anatomical differences and common health concerns. Here are a few examples:

In people with male anatomy:

• Benign prostatic hyperplasia (BPH). This is the most common cause of urinary retention. BPH causes the prostate, which sits just below the bladder and surrounds the urethra, to grow larger and press on the urethra, blocking the flow of urine.

• Prostate infection (prostatitis). This is an infection that causes the prostate gland to become swollen and inflamed. The swelling can lead to pain and irritation, and may also press on the urethra, blocking or slowing the flow of urine and causing urinary retention.  

In people with female anatomy:

• Pelvic organ prolapse. When the muscles and tissues that support the pelvic organs become weak, organs like the bladder or rectum can drop out of place and press on the urethra, making it harder to urinate. The most common type of prolapse, called cystocele, is when the bladder drops down and presses into the front of the vagina. This can change the angle or compress the urethra, making it harder to urinate or completely empty the bladder. Rectocele, or when the rectum bulges into the back of the vaginal wall, is more commonly associated with bowel symptoms like constipation, but in some cases, if severe, it could indirectly affect bladder function or cause difficulty emptying urine.

• Pregnancy and childbirth. Body changes during pregnancy and delivery can strain and weaken the bladder and pelvic floor muscles, making it harder for them to work together to fully empty the bladder. Urination requires the bladder’s muscular wall (the detrusor) to contract and the pelvic floor muscles to relax at the same time, allowing urine to flow out. Nerve changes or injury during childbirth, as well as hormonal shifts and temporary swelling, can disrupt this process and cause urinary retention.

• Gynecological surgery or procedures. Pelvic surgery — such as removal of the uterus (hysterectomy), pelvic organ prolapse repair, fibroid removal (myomectomy), sling procedures for urinary incontinence, or surgery for endometriosis — can sometimes lead to changes in pelvic floor muscle function or cause scar tissue near the urethra, affecting urine flow. 

Symptoms of urinary retention

Symptoms of urinary retention depend on whether your condition is chronic or acute. 

Chronic urinary retention usually develops over time and can cause a variety of symptoms, including:

• Feeling like you can’t completely empty your bladder: After urinating, you may still feel as though there’s urine left inside.

• Dribbling of urine: Urine may trickle out in small amounts.

• Difficulty starting urination: You may stand or sit for a while before your urine stream begins, also known as urinary hesitancy.

• Slow or weak urine stream: Your stream may be less forceful or take longer to finish.

• Feeling like you always need to pee: You may have a constant sensation of needing to urinate, even right after going.

• Leaking urine: You may leak pee with no warning or urge to go.

• Pain: You may feel lower abdominal pain or discomfort.

Acute urinary retention often comes on suddenly and may include symptoms such as:

• Inability to urinate at all

• Severe or sudden lower abdominal or bladder pain

• An urgent need to urinate

• Bloating or swelling in your lower abdomen

When to see a doctor

Acute urinary retention is a medical emergency. If you are unable to urinate or have severe pain or swelling in your abdomen, see a healthcare professional immediately. 

Chronic urinary retention often improves with treatment. However, contact your healthcare provider if you experience any of the following:

• Inability to urinate at all (complete urinary retention)

• Severe or sudden lower abdominal pain or bladder pain

• Visible blood in your urine (hematuria)

• Fever and chills (may indicate an infection)

• Nausea and vomiting (along with urinary symptoms)

• Confusion or disorientation (especially in older adults)

• New onset of urinary hesitancy after prostate surgery or other procedures

• Any symptoms of a urinary tract infection (UTI) — such as burning with urination, foul-smelling urine, or cloudy urine — especially if combined with hesitancy

Treatments for urinary retention

Acute urinary retention is a medical emergency. Your healthcare provider will immediately drain the urine from your bladder using a catheter. This can help ease your pain and prevent bladder and kidney damage.

Treatment for chronic urinary retention depends on the underlying cause of your symptoms. Your healthcare provider may recommend pelvic floor physical therapy and targeted exercises, bladder training, constipation management, medication to treat infections or other conditions contributing to symptoms, and in some cases, surgery. Here’s a closer look at treatments for chronic urinary retention:

Pelvic floor physical therapy

Physical therapy (PT) and targeted exercises are a key way to treat urinary retention caused by tight pelvic floor muscles. Pelvic floor muscles need to be able to tighten (contract) and fully release (relax) so they function properly. When pelvic floor muscles stay contracted, spasm, or have difficulty relaxing, it can lead to urinary retention and other symptoms.

Targeted exercises can help stretch and relax pelvic floor muscles to improve urine flow and bladder function. You can do exercise therapy at home or work with a physical therapist who can guide you through movements tailored to your needs. During physical therapy, a PT can assess you, help you modify your everyday activities that contribute to urinary problems, and empower you with tools and tips to help address incomplete bladder emptying.

Recommendations may include practicing healthy bladder habits or trying relaxation techniques.

Pelvic health physical therapists can be seen in person or, for those who qualify, through a program like Hinge Health with access to a physical therapist via telehealth/video visit. (See examples of pelvic floor exercises below.)

Bladder training

These are techniques that help train the muscles that control your bladder. Bladder training is most often used for people who urinate more frequently than “normal” (which is about seven times per day with two to four hours in between), but it can also help manage urinary hesitancy.

“As your bladder fills, it sends signals to your brain, which then tells the bladder to contract and release urine when you’re ready to go,” says Dr. Tipp. Your brain and bladder (along with the pelvic floor) constantly work together to coordinate urination, she explains. However, habits like routinely delaying bathroom breaks can disrupt this brain-bladder reflex over time.

Practicing how to relax and contract your muscles at the right times can improve coordination and may help reduce urinary retention symptoms. Here’s how to start bladder training:

1. Set an interval goal. Decide on a target amount of time you want to wait between bathroom visits (say, two hours between trips to the bathroom).

2. Make a schedule. Plan out and write down the actual times you’ll go to the bathroom based on your interval goal. For example, if you wake up at 7 a.m. and choose a two-hour interval, you’d set bathroom times at 7, 9, 11, and so on. Having a schedule helps keep you accountable and makes it easier to track your progress over time.

3. Practice urge suppression if you feel the urge to urinate before your scheduled time. Delaying even five minutes can help your bladder learn to wait to empty.

4. Gradually adjust the interval between bathroom breaks until you reach two to four hours between trips.

Constipation management

For some people, reducing constipation — through hydration, dietary fiber, and bowel habits — may help relieve pressure on the bladder and improve bladder emptying. Keeping your bowels regular with adequate fluid, a high-fiber diet, and healthy toileting habits can reduce pressure on the bladder and urethra, making it easier to urinate. Healthy toileting habits include going when you feel the urge, using a footstool so your knees are above your hips, and relaxing your belly and pelvic floor with diaphragmatic breathing during a bowel movement.

Medications

Medications to treat underlying conditions, such as antibiotics to treat a urinary tract or prostate infection, can help reduce urinary retention related to those causes. People with an enlarged prostate may be prescribed medicine to help stop the prostate growth.

Surgery or other procedures

Catheterization — a procedure in which a thin tube is inserted into the bladder to drain urine — is used for immediate relief in cases of acute urinary retention. It may also be recommended for chronic retention if other treatments don’t resolve the issue or if there is a nerve-related cause. For some, intermittent or long-term catheterization may be needed to ensure regular bladder emptying.

If a blockage — such as an enlarged prostate or a urethral stricture — is the cause, surgery may be considered to remove the obstruction and restore urine flow. Surgery may also be considered to treat urinary retention related to pelvic organ prolapse.

These exercises target specific muscles and functions that support healthy urination and help manage urinary retention. Diaphragmatic breathing eases pelvic floor tension and promotes relaxation, while seated pelvic tilts, standing groin stretches, and seated back bends boost mobility and flexibility in the pelvis, thighs and hips — reducing muscle tension and supporting the urinary system. Reverse Kegels train you to consciously relax your pelvic floor muscles, which is especially helpful if tension or spasms are making it hard to urinate. Consistently practicing these exercises can help restore optimal pelvic function, reduce retention symptoms, and make trips to the bathroom feel easier and more natural.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Tips to manage urinary retention

There are several simple lifestyle and self-care strategies — such as healthy bathroom habits, double voiding, warm baths, pelvic myofascial release, and relaxation techniques — that can help manage chronic urinary retention and prevent the condition from becoming more severe. Here’s more about each option:

Practice healthy bathroom habits

A few simple changes to your bathroom habits can relieve stress on your bladder and pelvic floor. Consider the following tips:

• Aim to urinate every two to four hours. Avoid going “just in case” too early or waiting too long when you really need to go — both can disrupt communication between your brain, bladder, and pelvic floor. This disruption can contribute to retention symptoms. Try to listen to your body’s natural cues and avoid either extreme.

• Try not to push or strain to empty your bladder. Straining can put stress on your pelvic floor muscles and contribute to hesitancy symptoms. “Pelvic floor muscles contract when you strain, which can make bladder emptying more difficult,” says Dr. Tipp. 

• Choose a relaxed position when you urinate. If you sit to urinate, make sure you’re fully supported — this helps your pelvic floor muscles relax, supports a steady urine stream, and allows your bladder to empty completely. Avoid hovering over the toilet seat, as it can keep your pelvic floor muscles from fully relaxing and make it harder for your bladder to empty completely. If you stand to urinate, keep your feet hip-width apart with your knees soft, and hinge slightly forward so your belly can relax to help your pelvic floor let go.

Try double voiding

“When you finish peeing, change positions and then try again,” suggests Dr. Tipp. “This helps the pelvic floor muscle contract and relax and can help fully empty your bladder.” If you sit to urinate, try gently shifting your position on the toilet — lean left, right, forward, and back, or make small circles with your hips — to help ensure your bladder is empty, says Dr. Tipp. If you stand to urinate, try sitting down or doing some diaphragmatic breathing to relax your pelvic floor muscles before trying again.

Take a warm bath

Soaking in warm water can help relax tense pelvic floor muscles, promote an overall sense of calm, and ease pelvic discomfort or tension that may be contributing to urinary symptoms.

Consider pelvic myofascial release therapy

Also known as trigger point therapy, myofascial release is a type of gentle massage that helps release tightness or restrictions in the connective tissue (myofascia) surrounding your muscles. For larger muscle groups like the inner thighs, abdomen, or hip flexors, you can use a small yoga or tennis ball to apply gentle pressure to trigger points. For smaller or harder-to-reach areas like the pelvic floor and perineum (the area between the anus and vagina or the anus and scrotum), a pelvic wand is often more effective. Pelvic wands are curved, medical-grade tools designed to massage and release tension in deep or tender pelvic muscles that can’t easily be reached with a ball. Applying sustained pressure to trigger points, or knots, in these areas can help release tension in tight pelvic muscles.

Try relaxation techniques

Deep breathing exercises and progressive muscle relaxation can help lower overall stress, ease muscle tension, and promote pelvic floor relaxation. Regular use of relaxation techniques can help your body adopt healthier restroom habits and reduce the anxiety that may sometimes accompany urinary symptoms.

What should I do if I can't urinate?

If you are suddenly unable to urinate, seek emergency medical treatment. This may be a sign of acute urinary retention — a serious condition in which you are unable to urinate even though you have a full bladder. Other signs of acute urinary retention include:

• Pain — often severe — in your lower abdomen

• Urgent need to urinate

• Swelling of your lower abdomen

PT tip: Try relaxing pelvic exercises

Kegel exercises, which help strengthen pelvic floor muscles, aren’t right for everyone — especially if your pelvic floor feels tight or you have trouble starting to pee or fully emptying your bladder. “It’s important to listen to your body — relaxation exercises can be more helpful than strengthening for certain pelvic symptoms,” says Dr. Tipp. If you’re dealing with urinary retention, reverse Kegels may be a good choice to practice regularly.

How Hinge Health can help you

If you have pelvic pain, bladder, bowel, or other pelvic symptoms that are affecting your quality of life, you can get the relief you've been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you. Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

1. Dougherty, J. M., & Aeddula, N. R. (2024). Male Urinary Retention. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK538499/

2. Dougherty, J. M., & Rawla, P. (2020). Female Urinary Retention. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK538497/

3. Grimes, W. R., & Stratton, M. (2023, June 26). Pelvic floor dysfunction. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK559246/

4. National Institute of Diabetes and Digestive and Kidney Diseases. (2019, December). Definition & facts of urinary retention. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/urologic-diseases/urinary-retention/definition-facts

5. Urinary Retention - National Association For Continence. (2025, February 22). National Association for Continence. https://nafc.org/urinary-retention/