What does it mean when you have to push to pee?

The need to strain or push in order to urinate can be due to problems with the contractile force of the bladder or problems with obstruction of the bladder outlet and urethra.

everydayhealth.com - Straining to Urinate? - Healthy Living Center - Everyday Health

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The need to strain or push in order to urinate can be due to problems with the contractile force of the bladder or problems with obstruction of the bladder outlet and urethra. Failure to empty due to problems with the contractile force of the bladder may be due to nerve-related disorders such as spinal-cord injury, multiple sclerosis, diabetes, and the like. Failure to empty the bladder due to urethral problems is unusual in women. Some causes of obstruction of the bladder outlet in women include prior vaginal or urethral surgeries, rare strictures of the urethra, and, in rare instances, polyps or cancerous lesions. Urinary symptoms should always be investigated to rule out some of these unusual but serious conditions. In the urologist's office, an evaluation for these symptoms would typically include a detailed history, physical examination including a vaginal speculum examination, urinalysis, and an ultrasound measurement of bladder volume after voiding. The most important thing that this latter test would show is whether or not the bladder is completely empty. If the bladder empties completely it makes neurological problems unlikely. If the bladder retains a lot of urine, further studies with urodynamics, a bladder-pressure study that assesses the contractility of the bladder muscle, would be appropriate.

Q2. My husband has been taking oxycodone for pain management for eight weeks now. He is currently having trouble urinating. I understand this is from the medication, but what can he do to overcome the problem? Would drinking more liquid help?

— Irene, North Carolina

Oxycodone, as well as other narcotic pain medications, can lead to bladder problems. Your husband's difficulty urinating may have resulted because the medication interacts with and blocks some of the nerve signals that cause the bladder to contract. If he cannot be switched to a nonnarcotic pain medicine, then additional evaluation is indicated to assess the severity of his urinary problems. Narcotic pain medicines can also lead to constipation, which, if severe, can prevent normal evacuation of the bladder. It is important to know whether your husband has an underlying predisposition to bladder difficulties. If he has an enlarged prostate, for example, lower urinary tract symptoms that are caused by prostatic enlargement may be exacerbated by a narcotic pain medication. In such cases, additional medication to treat the underlying lower urinary tract symptoms related to prostatic enlargement might improve his situation. It is unlikely that increasing his fluid intake will resolve bladder-emptying problems — this could actually exacerbate them. Any evaluation of a man who has difficulty urinating would also seek other, less common problems, such as chronic prostatic infection, prostate cancer, bladder stones, and the like.

Learn more in the Everyday Health Pain Management Center.

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What does shy bladder mean on a drug test?

Q1. Shy Bladder: A CDL driver could not provide enough urine for the random test within thee hours of his/her first unsuccessful attempt. The collector stopped the test and reported to the designated employer representative (DER) that it was not completed.

fmcsa.dot.gov - Shy Bladder | FMCSA - Department of Transportation

Q1. Shy Bladder: A CDL driver could not provide enough urine for the random test within thee hours of his/her first unsuccessful attempt. The collector stopped the test and reported to the designated employer representative (DER) that it was not completed. What happens in this situation?

A1. In this situation, referred to as a “shy bladder,” the driver has up to five days to obtain an evaluation from a licensed physician that contains a medical reason for the failure to provide a urine sample that would be acceptable to the medical review officer (MRO). The MRO must receive a copy of the evaluation and related medical records, and will decide whether the test is cancelled or declared a refusal. The regulations governing this process, including individual responsibilities are found in 49 CFR 40.193 and 40.195.

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