to an increased risk of postoperative urinary retention. The risk of postoperative urinary retention increases up to 2.11 fold for people older than 60 years. Medications: Anticholinergics and medications with anticholinergic properties, alpha-adrenergic agonists, opiates, nonsteroidal anti-inflammatories (NSAIDs), calcium-channel blockers and beta-adrenergic agonists, may increase the risk. Anesthesia: General anesthetics during surgery may cause bladder atony by acting as a smooth muscle relaxant. General anesthetics can directly interfere with autonomic regulation of detrusor tone and predispose people to bladder overdistention and subsequent retention. Spinal anesthesia results in a blockade of the micturition reflex. Spinal anesthesia shows a higher risk of postoperative urinary retention compared to general anesthesia. Benign prostatic hyperplasia: Men with benign prostatic hyperplasia are at an increased risk of acute urinary retention. Surgery related: Operative times longer than 2 hours may lead to an increased risk of postoperative urinary retention 3-fold. Postoperative pain. Chronic Chronic urinary retention that is due to bladder blockage which can either be as a result of muscle damage or neurological damage. If the retention is due to neurological damage, there is a disconnect between the brain to muscle communication, which can make it impossible to completely empty the bladder. If the retention is due to muscle damage, it is likely that the muscles are not able to contract enough to completely empty the bladder. The most common cause of chronic urinary retention is BPH. Other Tethered spinal cord syndrome. Psychogenic causes – psychosocial stresses, fear associated with urination, paruresis ("shy bladder syndrome") – in extreme cases, urinary retention can result. Consumption of some psychoactive substances, mainly stimulants, such as MDMA or amphetamine. Use of NSAIDs, or drugs with anticholinergic properties. Stones or metastases, which can theoretically appear anywhere along the urinary tract, but vary in frequency depending on anatomy. Muscarinic antagonists such as atropine and scopolamine. Malfunctioning artificial urinary sphincter. Diagnosis Analysis of urine flow may aid in establishing the type of micturition (urination) abnormality. Common findings, determined by ultrasound of the bladder, include a slow rate of flow, intermittent flow, and a large amount of urine retained in the bladder after urination. A normal test result should be 20-25 mL/s peak flow rate. A post-void residual urine greater than 50 ml is a significant amount of urine and increases the potential for recurring urinary tract infections. In adults older than 60 years, 50-100 ml of residual urine may remain after each voiding