Urecholine
25mg
Bethanechol 25mg tablets, used in the management of urinary retention. A muscarinic agonist that mimics acetylcholine to contract the bladder.
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Urinary Retention
Urinary retention means the bladder cannot empty adequately. Acute painful inability to urinate is an emergency, while chronic retention may be less obvious but can damage the bladder or kidneys.
Key points
- Prostate or urethral obstruction, pelvic prolapse, medicines and neurological disease are common causes.
- Acute retention usually needs prompt bladder drainage and cause assessment, not an oral medicine first.
- A weak stream, straining, overflow leakage or recurrent infection can indicate chronic incomplete emptying.
The catalogue is not a pathway for acute retention. A bladder-stimulating medicine is unsuitable when an outlet obstruction has not been excluded.
How is the cause assessed?
A bladder scan measures retained urine. Examination, kidney tests and medicine review help distinguish outlet blockage from weak bladder contraction. Diabetes, spinal disease, anaesthesia, antihistamines and anticholinergic medicines can contribute.
When can medicine help?
Bethanechol stimulates bladder contraction but has limited, cause-specific use and cholinergic adverse effects. Obstruction may require a catheter, prostate-directed medicine or procedure instead. See bladder health for context.
When to seek urgent care
Seek emergency care for sudden inability to pass urine with lower-abdominal pain or swelling. New retention with severe back pain, groin numbness or leg weakness may indicate spinal nerve compression and also needs immediate care.