We examine the urologic consequences of large-volume alcohol intake in light of recent advances in hollow viscera biomechanics and urinary tract pharmacology. Recent studies have shown that alcohol is depressive on the isolated rabbit detrusor. Patients teetering on or having manifest pelvi-ureteric junction obstruction or bladder outflow obstruction have been known to demonstrate symptoms on alcohol consumption. In men over 50, the cause is usually an enlarged prostate. Loin pain is precipitated in the case of the former and urinary retention in the latter case after consuming alcohol. Causation is difficult to prove for ethical reasons as well as the practical difficulties in running a prospective trial. It appears that a combination of rapid fill (due to diuretic effects), a weakened pump (due to the depressive effect of alcohol at least with the detrusor) and outlet obstruction lead to the loin pain and urinary retention seen in clinical practice. People liable to urinary tract obstruction would be well advised to avoid large volume alcohol intakes.
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