[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Nursing](https://durgical.com/en/nursing/) › [Nutrition and elimination](https://durgical.com/en/nursing/areas/nutrition/) › Urinary elimination: retention, incontinence and bladder scanning

# Urinary elimination: retention, incontinence and bladder scanning

- Fundamental

Nurses assess voiding, scan the bladder for a residual when retention is suspected, and manage incontinence without an indwelling catheter.

Updated Nov 5, 2026

## Key points

- Do not use an indwelling urinary catheter to manage incontinence (CDC 2009).
- The bladder scanner measures the post-void residual without catheterising; if it is above the protocol threshold, call.
- For bladder-emptying dysfunction, intermittent catheterisation is preferred over an indwelling catheter (CDC 2009).
- Palpate the bladder above the pubis to look for distension.
- Clean and disinfect the bladder scanner between patients.

## What it is

Urinary retention is the inability to empty all the urine from the bladder; it can be acute (for example, after anaesthesia) or chronic (for example, from an enlarged prostate). Incontinence is involuntary loss of urine and has several types. A portable bladder scanner measures, non-invasively, the urine left in the bladder after voiding (post-void residual). The CDC 2009 guideline says urinary catheters should not be used to manage incontinence.

## Key points

- Acute retention: sudden inability to void, for example after anaesthesia.
- Chronic retention: gradual inability to empty the bladder, for example from an enlarged prostate.
- Retention raises the risk of urinary tract infection.
- The scan is done with the patient supine and the probe above the pubis, aimed at the bladder.
- Indwelling catheters are avoided whenever possible, to reduce catheter-associated urinary tract infection.

## Components

- Assessment: habits, frequency, pain or difficulty voiding.
- Examination: bladder palpation and perineal skin if there is incontinence.
- Post-void residual by bladder scanner or, if ordered, by catheterisation.
- A voiding plan and a skin-care plan.

## What it is for

- Finding retention before it causes pain or infection.
- Avoiding unnecessary catheterisation.
- Protecting the skin from moisture in incontinence.
- Regaining continence with bladder training when possible.

## Types of urinary incontinence

| Type | What happens | Typical example or cause |
| --- | --- | --- |
| Stress | Leakage when coughing, laughing, jumping or straining | Weak pelvic floor after pregnancy, vaginal birth or menopause |
| Urge | Leakage after a sudden, strong need to void | Overactive bladder |
| Mixed | Combines urgency, frequency and stress | Several causes at once |
| Overflow | Small, frequent leaks from a bladder that never empties | Enlarged prostate |
| Functional | Normal bladder control, but cannot reach the toilet in time | Arthritis, limited mobility or dementia |

## In nursing practice

- Bladder training: pelvic floor exercises and timed voiding; improvement may take 3 to 6 weeks.
- Timed voiding: voiding on a set schedule, with or without the urge, gradually lengthening the interval towards about 4 hours.
- Advice: limit caffeine, manage constipation, cut fluids before bed and give ordered diuretics in the morning.
- Protect the skin from moisture with incontinence products and check the perineum.
- Speak with tact: incontinence is not an inevitable part of ageing.

## Common mistakes

- Placing an indwelling catheter to 'solve' incontinence.
- Catheterising without first measuring the residual with a bladder scanner, when the protocol allows it.
- Not palpating the bladder in a patient who voids small amounts often.
- Using the bladder scanner without cleaning it between patients.
- Not checking the perineal skin of an incontinent patient.

## Test yourself

Think of the answer, then tap the question to see it.

## What does a portable bladder scanner measure?

The urine left in the bladder after voiding (post-void residual), without having to catheterise the patient.

## Is an indwelling catheter used to manage incontinence?

No. The CDC 2009 guideline recommends avoiding urinary catheters to manage incontinence, because of the infection risk.

## Which type of incontinence causes small, frequent leaks in a man with an enlarged prostate?

Overflow incontinence: the bladder never empties fully and urine leaks out a little at a time.

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## Connections

## Related 2

- [Urinary catheterization](https://durgical.com/en/nursing/urinary-catheterization/)
- [Indwelling catheter care and removal](https://durgical.com/en/nursing/indwelling-catheter-care-and-removal/)

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Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order.

Sources: [Nursing Fundamentals, 16.4 Urinary Incontinence](https://med.libretexts.org/Bookshelves/Nursing/Nursing_Fundamentals_(OpenRN)/16%3A_Elimination/16.04%3A_Urinary_Incontinence) (Open RN (Chippewa Valley Technical College), LibreTexts, 2021); [Nursing Fundamentals, 16.5 Urinary Retention](https://med.libretexts.org/Bookshelves/Nursing/Nursing_Fundamentals_(OpenRN)/16%3A_Elimination/16.05%3A_Urinary_Retention) (Open RN (Chippewa Valley Technical College), LibreTexts, 2021); [Nursing Fundamentals, 16.9 Elimination: Applying the Nursing Process](https://med.libretexts.org/Bookshelves/Nursing/Nursing_Fundamentals_(OpenRN)/16%3A_Elimination/16.09%3A_Applying_the_Nursing_Process) (Open RN (Chippewa Valley Technical College), LibreTexts, 2021); [Guideline for Prevention of Catheter-Associated Urinary Tract Infections (2009): Summary of Recommendations](https://www.cdc.gov/infection-control/hcp/cauti/summary-of-recommendations.html) (Centers for Disease Control and Prevention, 2009).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/nursing/urinary-elimination-retention-incontinence-and-bladder-scanning/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/nursing/urinary-elimination-retention-incontinence-and-bladder-scanning/