Urinary retention is the inability to urinate or fully empty the bladder when urinating, leaving a postvoid residual. Drug-induced urinary retention is caused by various culprit drugs. According to observational studies data, up to 10% of cases of urinary retention may be related to medication use. It can be acute or chronic. Acute urinary retention can be a potentially life-threatening condition and requires immediate attention. Men are more likely than women to experience this condition.

Urinary retention can present with complete lack of voiding (full retention), incomplete bladder emptying (partial retention), or overflow incontinence. If left untreated, complications include, but are not limited to, bladder decompensation, bladder neck contractions, electrolyte imbalances, hydronephrosis, nephrolithiasis, renal failure, urethral strictures, urinary bladder calculus, urinary tract infection (UTI), and vesicoureteral reflux. Symptoms relating to complications may include abdominal distension, feelings of incomplete emptying, dysuria, foul-smelling urine, hematuria, incontinence, suprapubic pain, urethral discharge, urgency, and a weak urinary stream.

Women generally present with suprapubic pain and an inability to void, but some patients may be asymptomatic. Men generally present with double voiding, a feeling of incomplete bladder emptying, frequency, hesitancy, slow or weak urinary stream, and urgency.

Chronic urinary retention is generally milder, develops slowly over months to years, and has a varied presentation. It is usually painless and associated with an increased volume of residual urine. The condition may be asymptomatic, or patients may experience incomplete emptying, frequency, hesitancy, overflow incontinence, straining, urgency, weak or intermittent stream, or symptoms of renal failure over a length of time. It is possible for chronic retention to cause only lower abdominal distention, with no obvious other signs, symptoms, or precipitating event, and to be discovered only incidentally.

Older individuals are more at risk due to comorbidities and polypharmacy. Additionally, elderly patients who require anesthesia are at increased risk for acute urinary retention.

Classes of drugs more commonly implicated include anesthetics, antiarrhythmics, anticholinergics, antidepressants, antihistamines, antihypertensives, antiparkinsonian agents, antipsychotics, antispasmodics, benzodiazepines, calcium channel blockers, detrusor relaxants, hormonal agents, muscle relaxants, NSAIDs, opioids, sedative-hypnotics, and sympathomimetics (α-adrenergic and β-adrenergic agents). Ecstasy (3,4-methylenedioxymethamphetamine [MDMA]) abuse has also been associated.