DEFINITION: urinary retention is the inability to urinate, void, or pee
Temporary urinary retention without an uncomfortably full bladder may be managed with changes in medications and habits.
If the bladder feels painfully or uncomfortably full, urinary retention is an emergency and going to the ER and notifying your surgeon is important.

PREVENTION:
Prevention of urinary retention involves a combination of behavioral and pharmacologic strategies tailored to patient risk factors and underlying etiologies.
BEHAVIORAL:
- Avoiding constipation and eating an overall healthy diet
- Drinking mostly water
PHARMACOLOGIC:
- Alpha-1 adrenergic blockers (e.g., tamsulosin, alfuzosin) helpful temporarily for some patients
- Medications that cause retention: narcotics/opiods, anticholinergics, opioids, alpha-adrenergic agonists, and some psychotropics

MEDS TO AVOID OR MINIMIZE USAGE OF
If you have a history of difficulty urinating, medications to avoid or minimize usage include:
- Anticholinergics: Oxybutynin, tolterodine, trospium, darifenacin, solifenacin, fesoterodine (used for overactive bladder), as well as other medications with anticholinergic properties such as tricyclic antidepressants (amitriptyline, imipramine), first-generation antihistamines, and some antipsychotics (promethazine, haloperidol)
- β3-Adrenergic agonists: Mirabegron and vibegron, used for overactive bladder, have been associated with urinary retention
- Opioids: Morphine, codeine, oxycodone, and other opioid analgesics can impair bladder contractility and increase urinary sphincter tone
- Alpha-adrenergic agonists: Pseudoephedrine, phenylephrine, and other decongestants can increase urethral sphincter tone
- Calcium channel blockers: Amlodipine and other agents in this class can reduce detrusor contractility
- Antipsychotics: Both typical (haloperidol, chlorpromazine) and atypical (quetiapine, clozapine, ziprasidone) antipsychotics have been implicated
- Antidepressants: Tricyclics (amitriptyline, imipramine, clomipramine) are most commonly associated, but selective serotonin reuptake inhibitors (SSRIs) and other classes have also been reported
- Other agents: Benzodiazepines, nonsteroidal anti-inflammatory drugs (NSAIDs) have also been linked to urinary retention