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Published on: August 28, 2020
Non-neurogenic Chronic Urinary Retention: What Are We Treating?
1Department of Urology, University of Michigan, Ann Arbor, MI, USA. jstoffel@med.umich.edu.
Purpose Of Review:
This review examines current terminology used to define non-neurogenic chronic urinary retention (CUR), describes the pathophysiology of urinary retention, and highlights contemporary diagnostic and treatment algorithms.
Recent Findings:
There is no standardized definition for the condition, but volumes >300 ml are commonly used to describe CUR. It is a clinical diagnosis which does not require urodynamics. Pathophysiologic causes of CUR be from myogenic, neurogenic, bladder outlet obstruction, or a combination of these sources. Treatment algorithms recommend stratifying patients with chronic urinary retention by risk and by symptoms before initiating treatment. Common CUR outcome endpoints need to be better utilized so that treatment modalities can be compared. Non-neurogenic CUR is a heterogeneous condition that has multiple definitions, underlying physiologies, and possible endpoints. Standardization is needed to better understand and treat CUR.
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The Micturition Reflex
The process begins with bladder filling, where the bladder wall stretches as urine accumulates. This stretching activates the urine storage reflex, mediated by the sacral spinal segments and the pontine storage center. Efferent sympathetic impulses stimulate the detrusor muscle to relax and the internal urethral sphincter to contract, facilitating...

