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Case Reports
. 2024 Sep 3;16(9):e68587.
doi: 10.7759/cureus.68587. eCollection 2024 Sep.

Acute Urinary Retention and Severe Hyponatremia in a Patient With a Large Intramural Uterine Fibroid

Hoore Jannat  1 , Syed Sadam Hussain  2 , Hamad Ahmad  3
Affiliations
Case Reports

Acute Urinary Retention and Severe Hyponatremia in a Patient With a Large Intramural Uterine Fibroid

Hoore Jannat et al. Cureus. .

Abstract

Acute urinary retention (AUR) is defined as the inability to pass urine voluntarily. It is more common in males, with a male-to-female incidence ratio of 13:1. In males, benign prostatic hyperplasia is the most common cause of AUR, especially in men aged above 60, whereas in females, pelvic anatomy distortion secondary to pelvic organ prolapse and pelvic masses causes most cases of AUR. Prompt diagnosis and management are the keys to avoiding complications secondary to AUR, such as pain and acute kidney injury. Less commonly, it can cause acute hyponatremia, as was seen in our patient. Hyponatremia is generally asymptomatic, but if acute and/or severe, it can cause mental status changes, seizures, and coma. Such patients need closer monitoring of their mental status and sodium level to avoid overcorrection. Here we present a unique case report of a patient with asymptomatic large uterine fibroid presented with abdominal distention who was found to have acute urinary retention with associated asymptomatic severe hyponatremia, managed conservatively.

Keywords: acute urinary retention (aur); severe hyponatremia; syndrome of inappropriate secretion of antidiuretic hormone (siadh); urinary bladder decompression; uterine fibroid.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Blue arrows in pictures A, B, and C point to an enlarged urinary bladder in sagittal, cross-sectional, and coronal views, respectively, in the non-contrast computed tomography (CT) scan of the abdomen and pelvis.
Figure 2
Figure 2. Computed tomography (CT) scan with intravascular contrast confirmed a large heterogeneously enhancing uterine mass, which may be intramural or endometrial in origin, seen in cross-sectional and sagittal views in pictures A and B respectively.
Figure 3
Figure 3. Magnetic resonance imaging (MRI) of the abdomen pelvis shows a large 13.1 cm intramural uterine fibroid Grade 4 (yellow arrows).
See this image and copyright information in PMC

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