رجل عمره ٧٢ سنة عنده ضعف في تدفق البول منذ سنوات، وأخذ أمس دواء للزكام فيه مضاد احتقان. لم يتبول منذ ١٢ ساعة، ويشتكي ألماً أسفل البطن، والمثانة منتفخة ومحسوسة فوق العانة. الضغط ١٦٢/٩٤. ما الإجراء الأنسب؟

A 72-year-old man with years of poor urinary stream took a cold remedy containing a decongestant yesterday. He has not voided for 12 hours, has lower abdominal pain, and a distended bladder is palpable above the pubis. BP 162/94. What is the most appropriate action?

1. Give a strong diuretic to stimulate urine flow
2. Scan the bladder and insert a urinary catheter as ordered
3. Encourage him to drink two litres of water in an hour
4. Reassure him and reassess tomorrow morning

Answer: B) Scan the bladder and insert a urinary catheter as ordered. BPH plus decongestants or anticholinergics can cause acute retention. Bladder volume is scanned and a catheter inserted, and the culprit drug reviewed.