Does sitting on the toilet seat thinking how can I feel like I have to pee but can't despite trying so hard become a common practice? A strong urge to pee but only able to get a little out may be indicating a serious underlying issue.

Feel Like I Have to Pee But Can't, Why?

Undoubtedly this is urinary retention, but why does it happen? There are many causes and here we list some of main reasons to shed some light on this issue:

1. Blocked Urethra

Blocked urethra can happen to both sex and the common reasons include injury, scar tissue, blood clots, infection, pelvic tumors, stones, etc.

Even so, the main reason for blocked urethra in male is an enlarged prostate gland surrounding urethra. Prostate enlargement could be due to many reasons, like benign Prostatic Hypertrophy (BPH), prostate cancer or prostatitis

2. Nerve Problems

A disrupted nerve complex between the bladder and brain causes you to lose bladder control. In simple words, the problem is that the messages are not being passed, or that the nerve responsible for muscle contraction during urination dysfunction, or both.

Common causes of nerve disruption include spinal cord injury, spinal cord tumor, diabetes mellitus, stroke, herniated disc, ruptured disc, blood clot exerting pressure on spinal cord, infection, etc. Sometimes urinary retention could be the first sign of an emergency like spinal cord compression requiring immediate treatment in order to avoid any form of disability.

3. Infection

The answer to your question "Feel like I have to pee but can’t, why?" could also lie in an obvious cause like infection. An infection of the urinary tract occurs when bacteria gain access to the bladder. There will be a strong urge to pee, but little comes out even tough your bladder feels full. Besides, you may have a burning sensation or pain while passing urine.

Other kinds of infections also have an influence, like pelvic area infection that interferes with the local nerves, infection and inflammation that can lead to urethral compression and infection around spinal cord causing retention.

4. Surgery

Post-surgical urinary retention could be due to a number of reasons, like effect of anesthesia, type of surgery, immobility after surgery. Besides, history of bladder and prostate surgeries can lead to stricture formation causing retention.

5. Medication-Related Causes

Certain drugs make one prone to urinary retention, especially those already with prostate enlargement. Usually such drugs are one of the cold and allergy preparations available over the counter. These medications include

• Drugs narrow the urinary channel and obstruct the flow of urine, like ephedrine, pseudoephedrine and phenylpropanolamine.
• Antihistamines like diphenhydramine, chlorpheniramine as well as certain anti-depressants can cause bladder to relax and result in urinating issues.

6. Urinary Retention In Children

Children may have urinary problems from birth and may present symptoms in the first 6 months or may suddenly be reluctant to urinate because of pain. Child may eventually urinate without assistance. Underlying causes may include yeast infection of vagina (girls) and irritation from soap or shampoo.

7. Other Causes

Chronic retention occurs gradually with time and is diagnosed late because of the absence of symptoms. This can be caused by weak muscles, prolonged immobility, chronic obstruction, nerve disease or injury. This problem can lead to urinary incontinence, urinary tract infection or kidney failure.

What to Do About the Feeling Like to Pee but Can't

Now that you're familiar with the whys of "Feel like I have to pee but can't", let's discuss a few ways to deal with the problem. You can take certain steps to assuage the problem, like taking a shower with warm water or sitting in a tub full of warm water to stimulate the flow of urine. You should consult your doctor and stop the drugs that could trigger this retention and then observe the changes.

But if you can't solve this problem at home, if you condition affects you daily life or if this condition persists, visit a doctor and seek proper treatment options.

1. Take Medications

Medicines used to treat urinary retention include:

• Alpha receptor blockers reduce the obstruction of flow by relaxing the bladder neck muscles. Mostly used in long-standing cases, they can also relieve acute obstruction. Studies show that these drugs can improve overall condition if initiated early.
• 5-alpha reductase inhibitors shrink the prostate gland by inhibiting the conversion of testosterone into its metabolites, thus treating urinary problems due to enlargement. However, they have no effect in acute cases.

2. Drain Urine With A Foley's Catheter

In severe, painful and acute cases of urinary retention, a Foley's catheter is inserted in the bladder through urethral meatus.

• A bladder has a capacity of 400ml. If the amount of urine retained is more than this, a catheter will be left in place till the bladder contracts to its normal size.
• Whether to remove the catheter or not depends on the amount of urine obtained, underlying cause and the likelihood of recurrence.
• Sometimes, drained urine could be bloody or slightly pinkish. This is often minor and will stop on its own, but doctor will keep an eye on it to ensure it does stop.

3. Try the Suprapubic Route

If the access through urethra is not possible due to an obstruction, supra pubic route is used.

• This temporary procedure is performed by Urologists to make sure your situation can be managed by a cystoscopy procedure.
• Here catheter is inserted in bladder through skin over the pubic bone in the lower abdomen. With various types of dilators, urethral path can be widened enough to let a catheter pass.

4. Implantable Devices

Implantable devices can help tackle urinary retention by stimulating the nerves that control bladder. In few cases, these devices help the bladder contract and relax at the right time to allow urination.