Why do you have to pee before being discharged from the hospital?

September 29, 2025 •

3 min read

For some low-risk patients in ambulatory surgery, the incidence of urinary retention is less than 1%, but for many others, demonstrating the ability to void is a critical safety measure. This is why you have to pee before being discharged from the hospital following certain procedures and treatments.

Quick Summary

Demonstrating the ability to urinate before leaving the hospital is a crucial step to confirm normal bladder function, especially after surgery or anesthesia, and to prevent serious complications like urinary retention.

Key Points

Preventing Urinary Retention: The primary reason for requiring urination is to rule out postoperative urinary retention, which can cause significant damage to the bladder and kidneys.
Impact of Anesthesia and Medications: Anesthetics and narcotic painkillers can temporarily interfere with the nerve signals controlling the bladder, dulling the sensation of needing to urinate.
Identifying High-Risk Patients: Patients undergoing certain procedures (urological, pelvic), receiving spinal/epidural anesthesia, or having pre-existing prostate issues are at higher risk for retention.
Post-Void Residual Check: Healthcare staff use bladder scanners to measure the residual urine left in the bladder after voiding to confirm complete emptying.
Alternative Plans for Failure: If a patient cannot urinate, solutions may include temporary catheterization, teaching intermittent self-catheterization, or discharge with a catheter for later removal.
Reducing Hospital-Acquired Infections: Ensuring timely catheter removal and successful voiding helps minimize the risk of developing catheter-associated urinary tract infections.

The requirement to urinate before leaving the hospital is a standard safety protocol. This is because various factors during a hospital stay can affect the body’s urinary system. Healthcare providers must confirm that a patient's bladder is working correctly to prevent pain, infection, and potential damage to the urinary tract.

The Risks of Postoperative Urinary Retention

Postoperative urinary retention (POUR) is the inability to urinate after surgery despite a full bladder and is a common complication. Untreated POUR can lead to significant health issues:

Bladder overdistention: This can damage the detrusor muscle.
Urinary tract infections (UTIs): Stagnant urine increases infection risk.
Sepsis: A UTI can potentially lead to a life-threatening systemic infection.
Kidney damage: This can result from urine backing up into the kidneys.

Checking that a patient can void before discharge helps mitigate these risks, ensuring a safer recovery at home.

Factors Affecting Bladder Function in the Hospital

Several aspects of hospital care can interfere with normal urination:

Anesthesia: General, spinal, and epidural anesthesia can disrupt nerve signals to the bladder.
Pain Medications: Narcotic pain relievers can reduce the sensation of bladder fullness.
Fluid Administration: IV fluids can increase urine production.
Type of Surgery: Procedures on the genitourinary, gynecological, or anorectal systems are higher risk.
Catheterization: Removing a urinary catheter can temporarily affect bladder function.
Immobility: Being unable to move around can disrupt voiding habits.

The Voiding Trial Process

Hospitals often conduct a "voiding trial" or assess post-void residual (PVR) volume. The process typically involves:

Fluid Intake: Patients are encouraged to drink fluids.
Observation: Staff monitor for the return of normal voiding sensation.
Post-Void Residual (PVR) Check: A bladder scanner measures urine left after voiding. A PVR over a certain amount (e.g., 100-150 mL) may indicate incomplete emptying.
Assisted Techniques: Nurses may help by providing privacy or using a warm compress.

Discharge Protocols for Different Patient Risks


Feature	Low-Risk Patients	High-Risk Patients
Definition	Younger, no urinary issues, minor procedures.	Older adults, enlarged prostates, spinal/epidural anesthesia, relevant surgery.
Voiding Requirement	May not be required if no urge or bladder distention.	Usually required to demonstrate successful voiding.
Monitoring Tools	Monitor symptoms at home.	Bladder scans for PVR.
If Unable to Void	Given instructions for home monitoring.	May need recatheterization, monitoring, or urologist referral.

Managing Issues if You Cannot Void

If a patient cannot urinate or has a high PVR, the healthcare team will intervene. This may include:

Temporary Catheterization: A catheter may be reinserted temporarily.
Intermittent Self-Catheterization: Patients may learn to catheterize themselves at home.
Medication: Alpha-blockers may be used in some cases.
Discharge with a Catheter: If the issue persists, a patient may go home with a catheter and follow up with a urologist.

Conclusion

Requiring urination before discharge is a crucial safety measure to prevent acute urinary retention and its risks. Confirming bladder function helps avoid infection, pain, and long-term damage. While it may delay discharge, it's essential for a safe recovery. Patients can find more information on urinary retention from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

Frequently Asked Questions

Postoperative urinary retention (POUR) is the inability to urinate after a surgical procedure, even when the bladder is full. This can be caused by the effects of anesthesia, certain pain medications, and the type of surgery performed.

Anesthetics and narcotic pain medications can disrupt the nerve pathways that signal the need to urinate and control the bladder muscles. This can paralyze the sphincter or dull the sensation of bladder fullness, preventing you from urinating properly.

A bladder scan is a non-invasive ultrasound device used to measure the amount of urine left in the bladder after you've attempted to urinate. It helps medical staff determine if your bladder is emptying completely.

If you cannot urinate or a bladder scan shows a high residual volume, the staff may reinsert a temporary catheter to drain the bladder. You may be monitored for a longer period, given medication, or taught intermittent self-catheterization before you can be discharged safely.

Yes, if the problem is persistent and cannot be resolved in the hospital, patients can be discharged home with a catheter. They are given instructions for its care and for a follow-up appointment with a urologist for further evaluation.

Untreated urinary retention can lead to several complications, including bladder overdistention and damage, urinary tract infections (UTIs), severe pain, and potential kidney problems from urine backing up into the kidneys.

Tips to help promote urination include staying hydrated (unless directed otherwise by a doctor), mobilizing and walking around when possible, and creating a private, relaxed environment for voiding. Informing nurses of any difficulties is also crucial for timely intervention.