Why Do I Have Urinary Bladder Retention After General Anesthesia?

You can't go home until you pee.

— Hospital recovery room staff around the world

Urinating may seem like a simple enough condition to meet before leaving the hospital. Many people, however, find it difficult to empty their bladder after surgery. This frustrating condition is called POUR, post-operative urinary retention, and it is one of the most common side-effects of general anesthesia. It usually resolves with minor interventions, but some cases may result in over-distended bladders, urinary tract infections, and hospital admissions.

Up to 70 percent of patients have minor trouble urinating after surgery. One in 20 people experience more significant bladder retention problems. Find out more here whether you may be at risk of experiencing POUR after surgery and some strategies to discuss with your doctor.

Trouble Urinating After Surgery


General anesthesia becomes safer with each passing decade. The medicines used to put a patient under do, however, change how your body works. General anesthesia drugs affect brain function and inhibits the autonomic (involuntary) nervous system that triggers urination. The result is that the detrusor (bladder muscle) contractions are suppressed or decreased. This is an effect of both IV agents and gases used during general anesthesia.

Am I at Risk of Experiencing Urinary Retention?

If you meet most of these criteria, you may be at risk of experiencing urinary retention. Ask your doctor before surgery about whether the medications you are taking (or will take) put you at higher risk.

  • Over 50 years of age.
  • Male (especially with preexisting enlarged prostate).
  • Lengthy surgery and anesthesia time.
  • Undergoing pelvic or hernia repair surgery.
  • Increased administration of IV fluid (over-stretching the bladder makes it harder to empty after general anesthesia).
  • Many types of medications taken or given before, during, or after surgery (beta-blockers, for example).

Managing Urinary Retention During and After Anesthetic

If you have a surgery scheduled and are concerned about urinary retention, talk to your doctor. Be sure to discuss the importance of complete urination before the operation and ask whether any of these strategies may be appropriate for you:

  • Bladder ultrasound during surgery. This technique may help operating-room staff monitor whether your bladder is reaching capacity.
  • Movement after surgery. Sitting up, standing, and walking as soon as is safe after your operation may help stimulate urination.
  • Medication. There are drugs available to counteract the effects of anesthesia on the area of the brain that controls urination.

Healthy Bladder Function After Anesthesia

Structure of the Urinary Bladder (via Wikimedia Commons).
Structure of the Urinary Bladder (via Wikimedia Commons). | Source

A healthy bladder is a fairly complex, sac-like organ. Composed of a body and a neck, the bladder is made of different types of muscle fibers and nerves that interact to allow micturition, or the passage of urine. Emptying the bladder requires input and action from the bladder, surrounding muscles, spinal cord, brainstem, and brain.

The bladder's body holds the urine. There are stretch receptors in the walls of the bladder body that indicate the level of fullness of the bladder. These special sensors send signals to the brain when the bladder should be emptied. The neck of the bladder has sphincters or valves that open to allow urine to be expelled.

  • The internal urethral sphincter, located inside the neck of the bladder, is made of smooth muscle fibers and is not under voluntary control.
  • The external urethral sphincter is a ring formed by the pelvic floor muscles (striated muscle) and is under voluntary control.

Emptying the bladder is both voluntary and involuntary. Spinal reflex pathways control urination under the regulation of higher centers in the brain. The brainstem contains a “storage” center and a “micturation” center (pontine storage center and pontine micturation center) that feed information to the spinal pathways that in turn send signals to the bladder.

When the bladder needs to be emptied, the body of the bladder contracts. Then the internal sphincter relaxes, due to input from the parasympathetic nervous system (part of the involuntary nervous system). The brain tells the external sphincter muscles to relax (the voluntary part of the process) and the urine exits through the urethra.

Complications Related to Urinary Retention

More than just an annoyance, bladder retention after general anesthesia can lead to significant consequences.

  • Prolonged retention of urine has been linked to urinary tract infections. An overfull bladder is more likely to be incompletely emptied, which is a risk factor for infection. Also, if a catheter has to be used to relieve the retention, this increases the risk of infection, as well.
  • Longer-term issues with bladder emptying is another risk. There is some evidence that having an over-distended bladder can cause difficulty in emptying the bladder even after leaving the hospital.
  • A stretched bladder signals the nerves of the parasympathetic nervous system, which can affect other organs with parasympathetic nerves. This can result in slowed or irregular heartbeat, low or high blood pressure, and nausea/vomiting. These can occasionally be dangerous. Cardiac arrest is an unlikely, but possible, result.

Answer This Poll!

Have you experienced post-operative urinary retention?

  • No but I want to know more about it.
  • Yes but it was resolved.
  • Yes and I still have bladder trouble.
  • I'm not sure.
See results without voting

A Resolved Case of Post-Op Urinary Retention

A 75-year-old man arrived in the recovery room after a surgery of about 1.5 hours under general anesthetic.

Upon arrival, the man was agitated and not able to answer questions. His blood pressure was high but his heart rate was low. He was assumed to be in pain, given his agitation, but didn't improve much after medication. He began to sweat and experience ectopy (irregular heart beats).

The anesthesiologist and recovery nurse realized he had not emptied his bladder before going in for surgery. He had a history of prostate enlargement and had received over a liter of IV fluids in the operating room. His bladder was emptied with a urinary catheter. Almost immediately, his heart rate climbed back to normal, his blood pressure corrected, and his agitation disappeared. After a short nap, he woke up feeling just fine with no recollection of having the catheter placed. He had no further issues and was discharged to go home.

General Anesthesia and Bladder Function

As summarized in the above video, there are many points along the pathway that could interrupt normal bladder emptying.

A Final Word

Note: While the author is a board-certified physician-anesthesiologist, this article is for informational purposes only and should not be taken as medical advice or used for diagnosis or treatment. Consult your physician if you are concerned about post-operative urinary retention.

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Comments 31 comments

Yvonne 12 days ago

Please could anyone tell me which drugs are used to counteract the effects of anesthesia on the area of the brain that controls urination?

Three months post op' my husband still has a catheter.

Phil Beeson 2 weeks ago

Had back surgery 9/12/16 and a good job was done by my surgeon. No after pain. However the catheter remains to this day 10/7/16. Today I have an appointment with a urologist and am hope full for a good outcome.

Irene 7 weeks ago

I visited my father today who is 58 years old at the Rehabilation Center. He had a lower back surgery five days ago. I found out that he has a problem emptying his bladder. I did not ask anyone there and got so concern when I got home. I surf on the internet about this problem and I found your article. It's helps me a lot to understand by reading it and by reading some of the comments. I hope he will recover soon. This is his first surgery and it's hard for me to see him in pain.

Older and wiser 8 weeks ago

I had bilateral hernia repair yesterday The hospital staff made sure I urinated before and after surgery before sending me home. I was drinking a lot of water and passing too. I had terrible pain when I coughed so I took Wallgreen's version of Robitussen along with 600 mgs of Advil 3 times with 4 hour intervals. Coughing stopped pain subsided woke up this morning OMG no urine at all! Switched pain med to Tylenol and stopped cough meds. Drank cranberry juice lots of water thank God I was able to urine. Thanks for information

Floridagal 2 months ago

I had spinal surgery on 8/4/16. It's now 8/28 and I'm just starting to urinate without pushing and only getting a small amount. I'm 65 and this is my 4th back surgery. I've never had this problem before. It is very painful because of the pain in my spine and pushing is almost more than I can take. I seem to do better after moving around during the day but when I get up at night, I have a terrible time emptying my bladder. No one ever told me about this problem.

forest lover 2 months ago

Prior to hip replacement I had managed an enlarged prostate without medication with the usual stinging, dribbling, frequency etc. In recovery I could not urinate so they catheterized me. I was given a flowmax which did not really help. I struggled to produce a few drops with many failing attempts so they catheterized me again. This procedure was painful and the nurse knew it and apologized beforehand. After the second I passed undiluted blood with the attempts. Just before release a doctor I did not know came in and told be I should be catheterized upon release while waiting for a urologist exam. (Good thing I did not as my appointment is a one month wait) I fought this verbally as I was passing some urine, though very little. So the catheter was removed and I had two "successful " attempts where the ratio of urine in the catch bowl was around 500 cc and retained (seen by ultra sound hand instrument) was 50cc, if memory serves. This article is excellent and should be available to all patients with any kind of urine problem. The discharge doc seemed to think the third or more catheterizations would be better by getting a smaller catheter. Later the nurse told me she had never seen a smaller catheter. ( I wonder how that doc would have faired with a catheter, though he meant well and his advice was based upon sound experience of er trips and infections). They let me go with flow max and I am at home and urinating every couple hours with no blood. This article did not speak of the reason that supine periods drastically increase frequency of urination. Best wishes to all fellow travellers.

Mike 3 months ago

I just had hip replacement surgery yesterday. Once I finally was able to urinated, I've been going every 30-60 minutes, but only small amounts. And when it hits me it's painful. This has been horrible since it's so hard to move with a new hip day 1 &2.

dilip 4 months ago

I am 65.prostate surgery was done due to enlargement.Bleeding didnot stop post surgery and found tobe clotting factor 9 deficient.I am ok after the factor was injected.Before that the cystoscopy was done 3 times to remove clots in bladder.Now i am urinating drop by drop.there is retention of urine always.I will take an appointment of urologist again.

Adrianne 4 months ago

My husband had thoracic laminectomy and fusion in April and was catheterised and still is. We are being told it will eventually return to normal, but this is taking a long time. He had a problem with his prostate before surgery, some years ago, but this is controlled with medication. He saw a urologist within two weeks of discharge, who said this would take time.. we don't really know what the problem is. He is 72.

Patient Modesty 13 months ago


This was a well-written article. I appreciate you bringing attention to what factors could cause to urinary bladder retention after surgery. As the founder of Medical Patient Modesty (, a non-profit organization that works to educate patients about how to stand up for their rights to modesty and maximum amount of modesty for procedures, I am very concerned about how often unnecessary urinary catheterizations are done. One of our goals is to reduce number of unnecessary urinary catheterizations due to modesty concerns and complications such as UTI. I appreciate you mentioned that a catheter could cause UTI. I feel we need to educate patients and medical professionals about how to take precautions to reduce the chances that a patient would have urinary retention so urinary catheter can be avoided.

You can find an article about how informed consent is missing from urinary catheterizations at

I could not find your email address. I would love to correspond with you via email further. You can find email address for MPM by going to the contact page.


slack 14 months ago

Went in for minor surgery at VA hospital, peed before going under and was sent home afterwards without the slightest knowledge that I might not be able to pee. Which is exactly what happened. Languished til 4:00 in the morning, with the urge to go but inability to do so before driving frantically to the e.r. where they shoved down a catheter. My first and hopefully my last. ..who knew???...5 days later still trying to recover.

bill tramontozzi 17 months ago

I have bph. Biopsy on my prostate shows no cancer. I had this problem twice. Once with a colonoscopy and once with double hernia laposcopic surgery. Both times I ended up going the the emergency room and both times a catheter was inserted. Very uncomfortable and leary about future surgery if needed.

felix 2 years ago

if you have complicated urinary tract issues on the west coast please see Dr Joel Gelman in Orange California. If you have the same problem on the East Coast please see doctor purohit at the uro center in New York City.

rather be hiking 2 years ago

I recently had outpatient surgery under general anesthesia. I was sent home without voiding. I went 11 hrs without going & ended up in ER. I was vomiting & very dehydrated. I was admitted and became very sick. I'm a healthy active young 45yr old & can not believe that this happened. Its been a week aand I'm still trying to recover. All this because I should of never been sent home without peeing! I hope this never happens to anyone else.

wetweather 2 years ago

Thank you. This explanation was very helpful.

Yesterday, I had minor surgery. I was not allowed to go to the bathroom before surgery (even though I asked) but kept getting more IV fluids for about two hours. When I awoke in recovery, I was panicky and shaking and desperate to go the bathroom. I've had surgery before, but never felt panicked. I was terrified and cried. I begged to go to the bathroom but the nurse assured me I would have been catheterized during surgery and said I did not need to go. I kept asking and they finally let me get up and go. It turned out I had wet myself and was soaked and still plenty for the bathroom. I think I was like that 75 year old man. If I have to have surgery again, I guess I'll make sure I go first and ask them to dial back on the IV fluids. I'm not that big.

John 3 years ago

A great read

Jmillis2006 profile image

Jmillis2006 3 years ago from North Carolina

Great hub, this actually happened to me in 2006 after a hernia repair surgery, the surgery was outpatient but I ended up back in the ER later that day because of this and had to have a catheter for 5 days. Worst experience ever. Voted up.

Funom Makama 3 profile image

Funom Makama 3 3 years ago from Europe

Keep up with the good work. This is your second medical hub I am digesting today. I think I really would want to learn a lot from you.

buckwheats 4 years ago

for sure! thank you!

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Wow, buckwheats- you are certainly dealing with a lot, yourself. All I hope is that people who have their health never take it for granted (which is really easy to do, until you don't have it).

Take care of yourself and thanks for stopping by.

buckwheats 4 years ago

i have been trying to find the right place to tell you that i have an ostomy not because of UC but IC. I had my bladder removed 13 years ago and it never cured the frequency. i can hardly leave my home because it is so extreme. i am sorry you have had a battle with UC. A close friend of mind is presently fighting for his life again as a result.

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Shane- sorry, it sounds like you are pretty miserable and I'm sure you are getting frustrated by not having any answers.

Unfortunately, I don't have any either. I can't find any good literature about the effects of marijuana on the bladder, except to increase the risk of bladder cancer. I'm not suggesting you have bladder cancer as they would have (most likely) seen this on the cystoscopy if you did.

It is used to treat urinary incontinence - the loss of urine when you don't want to. It seems possible that if it can prevent incontinence, maybe it goes farther in some people and causes retention. I have no good scientific basis to say that, though. It's purely speculation.

The anesthesia can cause temporary retention as you read in this hub. It should not cause long-term problems, though.

You are in the right place with the urologist. If you don't get answers, don't be afraid to ask more questions. Also, make sure they know about the mj use as they may have more knowledge about potential effects on the urinary system.

I wish I could help you but this is really out of the scope of my practice. Follow up with the urologist. Sorry Shane :(

Good luck! I hope you get some answers soon.

shane 4 years ago

my name is shane im 25 years old and i have been experiencing bladder problems for quite some time. It seems to be worse after a surgery or when i have smoked marajuana sometimes not emptying at all. I have been to see a urologist and had cystocpy and uradynamics test back yet to no avail. If anyone could give me some insight that would be fantastic as its starting affect my life and make a single trip to the toilet a nightmare. My email is if anyone can get back to me that would be fantastic

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Thanks everyone! I was reminded of this issue again the other day when my patient could't pee after surgery. Took a while, but we got her home with no problems :) This is really very common I'm glad you all find it 'readable'. That means a lot.

Amy Gillie profile image

Amy Gillie 4 years ago from Indiana

This is such an interesting hub! I love the diagrams and sidebars. And, I feel like I completely understand the condition and its causes. Voted up!

alliemacb profile image

alliemacb 4 years ago from Scotland

This is a great hub and very interesting to read. The way you set out the main points, along with the video and diagrams made the topic easy to understand. Voted up.

Horatio Plot profile image

Horatio Plot 4 years ago from Bedfordshire, England.

You made what could have been a boring piece of text really interesting. Held my attention all the way through. What a great bit of writing. Loved the "From the Operating Room..." section. House, eat you heart out.

I love stuff where I know more at the end than I did at the beginning. Up and shared.


habee profile image

habee 4 years ago from Georgia

Wow - I love the way you explained this. Luckily, I've never had a problem "going" after surgeries. I was already to go home! lol. Voted up!

Marcy Goodfleisch profile image

Marcy Goodfleisch 4 years ago from Planet Earth

Excellent and very informative hub! I had not heard this was an actual diagnosis, but I've known of it happening, and it is extremely uncomfortable for the patient. It is so helpful for those of us who are non-scientific to have understandable information about things we might encounter.

Voted up, useful and interesting!

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Thanks for the reminder Dr. Kate- I wanted to include a reference to a great article for health care providers. I will go add it now. This was a tough one to write because more words would be WAY boring and too few words would not provide enough explanation. I hope this helps some curious souls understand this common issue.

FutureDrKate 4 years ago

Great hub! Voted up. I had forgotten a lot of the physiology. I always wondered about this because on some services the residents would keep patients till they voided and then on other ones I would assume that and they would ask if we were anywhere near the bladder (ex after thyroid surgery).

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