Can anticholinergic agents cause urinary retention, and if so, how?

Anticholinergic agents can indeed cause urinary retention, and the mechanism involves their action on the detrusor muscle of the bladder. These medications work by inhibiting the activity of the neurotransmitter acetylcholine at muscarinic receptors, which are responsible for stimulating the detrusor muscle to contract during urination. By blocking this stimulation, anticholinergic agents reduce the contractions of the detrusor muscle, thereby inhibiting the normal urge to void and increasing bladder capacity. This results in difficulty initiating urination and often leads to urinary retention.

Understanding this mechanism highlights the importance of recognizing potential side effects, particularly in populations where urinary retention can pose a significant concern, such as the elderly or individuals with preexisting urinary issues.