Occult Perirectal Abscess Causing Acute Urinary Retention

Acute urinary retention (AUR) is a common symptom evaluated in the emergency department. It is generally due to an obstructive process such as benign prostatic hyperplasia (BPH) and can be treated simply with an indwelling foley catheter and urological follow up. Perirectal abscess is a relatively rare cause of urinary retention with no documented prevalence but when present is almost universally accompanied by perirectal pain. We present a 53-year-old male with a four-day history of urinary retention without perirectal pain or additional symptoms, who was found to have a perirectal abscess on digital rectal exam (DRE) and confirmed on computed tomography (CT) imaging.