Can bladder with no urge bounce back?

Dear Dr. Roach: I am going to be 98 in July. A few months ago, I had a bad cough for weeks. My internist gave me guaifenesin with codeine. The medicine got rid of the cough, but I developed the inability to urinate. I went to the ER and they drained 2 liters of urine from my bladder. I had to go home with a catheter.

I don’t have pain, but I still do not have the urge to urinate. My urologist performed a few tests and said that I would need the catheter for the rest of my life.

Can I do anything to help my bladder go back to normal? — L.L.B.

Urinary retention is the inability to drain the bladder. It’s seen in both men and women, but the more likely causes for each are very different.

One common cause is medication side effects. Codeine can cause urinary retention; however, this should go away within a few hours of stopping the medicine. Given the timing you describe, I can’t believe it is due to the cough medicine, and I am sure your urologist looked at any other medicines you might be taking.

Men and women both also can develop an obstruction to urinary flow. In men, this is usually due to an enlarged prostate, whereas in women, it may be from other anatomic abnormalities that come with aging. But the fact that you were holding 2 liters of urine in your bladder and had no urge to urinate suggests a neurological cause as your underlying problem.

These are often difficult to treat. Some causes require urgent treatment, such as spinal cord injury; you would have known if that were the problem.

Your urologist may do (or have done) more extensive tests on your bladder function and the function of the associated nerves. Talk to your urologist a bit more about what he or she suspects as the underlying cause, and write back.