Patients at Duke have several options for treatments for difficulty with bladder emptying, including surgery, sacral nerve stimulation, or self-catheterization.

Because there are a variety of causes, a number of treatment options exist. With some causes cure can be expected, but in others the only recourse may be self-catheterization.

Duke's urogynecology specialists will ensure that the best treatment is made available to you.

Treatment options include:

• Surgery: If your inability to empty the bladder occurred after a surgery to correct incontinence, the outlet in the urethra may be too tight. A urethrolysis or "take down" of that surgery may be performed to allow for improved voiding, usually with little risk of getting the incontinence back.
• Sacral nerve stimulation: If urinary retention does not improve with behavioral therapy, and you are not obstructed, then stimulating the nerves to the bladder may help improve emptying your bladder.
• Self intermittent catheterization: This is the least attractive option to treat urinary retention, but if it is necessary we will teach you how to do it quickly and painlessly. Many patients fear the risk of infection, however this is minimal.

Instructions for Self-Catheterization

1. Wash your hands and genitals using warm soapy water.
2. Lubricate the tip of the catheter with a water-soluble lubricating jelly (not petroleum jelly).
3. Relax when inserting the catheter. Tense muscles make the catheter harder to insert.
4. Insert the catheter by first spreading the labia. You may want to use a mirror or index finger to locate the urethra hole.
5. When urine starts flowing, stop inserting the catheter.
6. When urine stops flowing, remove the catheter.
7. Wash the catheter in mild soap and water, rinse it well, and let it air-dry.
8. Store the catheter in a clean, dry container.