Acute Urinary Retention

Author: Melanie Buchmann / Editors: Yasmin Sultan / Reviewer: Michael Perry / Code: / Published: 11/11/2020

A 51-year-old male is seen in the Emergency Department (ED) with severe abdominal pain and inability to pass urine. He slipped while attempting to get out of bed in the morning, landing on the bed rail on his abdomen.

On further questioning, he reports his pain to be in the suprapubic region which started suddenly after he had landed on the bed rail this morning. He rates the pain 8 out of 10, sharp and stabbing in nature and is continuously present since the incident. The pain radiates into his scrotum and is associated with a background history of 2 days constipation and an episode of dysuria last night.

His observations are as follows:

Temperature: 37.7oC

Pulse Rate: 146

Blood Pressure: 167/115

Oxygen Saturation: 97%

Respiratory rate: 18

On examination, you find the following:

Respiratory and cardiovascular exam nil to note

Abdominal exam tender around suprapubic region, no masses, lower abdomen distended, bowel sounds present.

Scrotal exam: yellow smelly uretheral discharge, red spots on glans, pain on foreskin retraction, phimosis, scrotal tenderness, no scrotal masses felt

Rectal exam: attempted but not completed due to severe anorectal discomfort

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