رجل عمره ٧٩ سنة عنده تضخم بروستاتا، جاء بتعب وقلة بول وتورم بسيط. البطن منتفخ أسفله، وقياس المثانة ١٢٠٠ مل. الكرياتينين ٣٫٤ وكان ١٫١ قبل شهرين، والأشعة تظهر تضخم الكليتين. بعد تركيب القسطرة، ما المراقبة الأهم في الأيام التالية؟

A 79-year-old man with BPH presents with fatigue, low urine output and mild oedema. The lower abdomen is distended and the bladder scans at 1,200 mL. Creatinine is 3.4 (1.1 two months ago) and imaging shows bilateral hydronephrosis. After catheterisation, what is the key monitoring over the next days?

1. Visual acuity and pupil size for the first hours
2. Bowel movements and stool type each day after catheterisation
3. Large post-obstructive urine output, electrolytes and fluid balance
4. Grip strength and reflexes in the lower limbs only

Answer: C) Large post-obstructive urine output, electrolytes and fluid balance. After relief of chronic obstruction, post-obstructive diuresis can cause dehydration and electrolyte imbalance. Monitor urine, weight, BP, sodium and potassium and replace fluids as needed.