It is the sudden inability to void adequately despite having a full bladder.
It is a common emergency, especially in older men.
The patient may present with:
In men, a common cause is obstruction secondary to benign prostatic enlargement.
It can also be caused by:
The priority is to decompress the bladder.
An attempt is usually made to place a urethral catheter.
Repeated, traumatic attempts should not be made.
Consider:
Urologic evaluation may be required and, in certain situations, suprapubic drainage.
⚠️ Alert
If urethral injury is suspected, especially after pelvic trauma, avoid blind urethral instrumentation.
Key concept
Acute retention → drain the bladder first; then investigate and treat the cause.
In urological emergencies, the initial goal is often not to definitively resolve the disease, but to recognize the risk, stabilize the patient, and drain or preserve the organ when appropriate.
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