A Case of Female Acute Urinary Retention Presenting to the ED

Abstract

Introduction: Acute urinary retention is a rare occurrence in women necessitating further investigation. Potential underlying causes may be broadly classified into obstructive, neurological, pharmacological, and psychogenic categories.

Case: A 36-year-old nulliparous female presented to the Emergency Department with a two-day history of acute urinary retention. Point-of-care ultrasonography and CT scan imaging confirmed the presence of a large uterine mass causing compression of the bladder. The acute retention was relieved with urethral catheterization. A Uterine leiomyoma was confirmed on histology after hysterectomy.

Discussion: Once the acute urinary retention has been relieved by insertion of a urethral catheter, the underlying cause of the obstruction must be determined. Although uterine leiomyoma is a fairly common finding in the general population, it is an extremely rare cause of acute urinary retention in women with just a handful of reported cases in the literature.

Figure 1

Abdominopelvic ultrasound study showing a well-defined uterine mass measuring 10,5 cm × 10,6 cm.

Figure 2

Pelvic CT scan outlining the uterine lesion (white arrow). The compressed bladder lumen is also illustrated (white stars).