← All presentations
FOCUSED SHIFT VIEW

Urinary Symptoms & Acute Retention

Measure the bladder, relieve obstruction safely, and never miss cord compression or sepsis.

Open full pathway
Educational first-pass aid. Reassess the patient, confirm doses and use local protocols.

1 · First minutes

  1. Assess for sepsis, renal failure, neurologic deficits, and painful distension.
  2. Use bladder scan and urinalysis; decompress acute retention using local catheter practice while tracking output.
  3. Escalate early for suspected cauda equina, infected obstruction, traumatic catheterization risk, or recurrent retention.

2 · Escalate now if

  • Saddle anesthesia, bilateral weakness, or new bowel dysfunction
  • Fever/shock or rigors with urinary symptoms
  • Anuria, AKI, or a solitary kidney
  • Gross hematuria/clots or traumatic catheterization
  • Known malignancy, recent spinal procedure, or IV drug use with back pain

3 · Immediate workup

  • Bladder scan, urinalysis/culture when infection suspected, pregnancy test when relevant
  • ECG/electrolytes/creatinine for significant retention, AKI, or systemic illness

4 · Don’t miss

  • Cauda equina syndrome / spinal cord compression
    Back pain with saddle sensory change, new retention/incontinence, bilateral symptoms, or weakness needs urgent MRI and spine review.
  • Urosepsis / infected obstruction
    Systemic illness with urinary source needs sepsis treatment and source-control assessment.

5 · Disposition lane

Admit / urology

AKI, recurrent/complicated retention, infection, difficult catheterization, or high-risk anatomy.

Urgent MRI / spine / resuscitation

Cauda equina/spinal compression or sepsis with obstruction.