[Chronic monstrous urine retention].

Area of Science:

• Urology
• Radiology

Background:

• A 75-year-old male presented with abdominal girth and infrequent voiding, later diagnosed with a renal mass and mesenteric cyst.
• Initial examination suggested urinary retention, with normal creatinine and no hydronephrosis.
• Renography indicated equal renal function but prolonged bilateral outflow.

Observation:

• A significant finding was the extraction of 15 liters of urine via urethral catheterization.
• This extreme volume of chronic urinary retention was unusual given the absence of hydronephrosis and normal serum creatinine levels.
• The patient's infrequent voiding habit, developed over years as a taxi driver, contributed to the condition.

Findings:

• The case challenges the typical presentation of chronic urinary retention, where hydronephrosis is commonly observed even with smaller urine volumes.
• This presentation suggests that significant urinary retention can occur without immediate renal compromise or visible hydronephrosis on imaging.
• Median cystic processes on imaging should prompt consideration of underlying urinary retention.

Implications:

• Clinicians should consider urinary retention in patients with median cystic masses, even without overt signs of renal dysfunction.
• The findings expand the spectrum of clinical presentations for severe urinary retention.
• This case underscores the importance of thorough patient history and physical examination in diagnosing conditions like urinary retention.