URINARY RETENTION: AN ALARM SIGNAL OF BENIGN PROSTATIC HYPERPLASIA

The prevalence of lower urinary tract symptoms (LUTS) in men increases with age and has a great impact on quality of life. It’s one of the most frequent reasons for consultation in primary health care among adult men. The acute urinary retention could be one of the main signs of chronic obstruction caused by benign prostatic hyperplasia (BPH). Man, 65 years, with a history of essential arterial hypertension, type 2 diabetes mellitus, dyslipidemia, overweight and ex-smoker. On May 6th 2013, he went to a consultation with complaints of hypogastric abdominal pain, with 10 hours of evolution and progressive worsening, coupled with the absence of urination. A catheterization was carried out and symptoms have resolved. Once the clinical picture of LUTS was suggestive predominantly of emptying symptoms (obstructive), catheterization was kept one week, the patient was treated with antibiotics and α1-adrenoceptor antagonist and diagnostic tests were made looking for possible obstructive causes (bladder, renal and prostate ultrasounds, urine II, creatinine and prostate specific antigene). On May14th, the catheter was withdrawn and spontaneous urination returned. He continued to take α1-adrenoceptor antagonist. Two weeks later the medical exams confirmed an acute urinary retention secondary to BPH. As the BPH progresses, complications may occur, such as urinary tract infections, urinary stones or chronic urinary retention. Acute urinary retention may be the first clinical finding for the diagnosis when patients do not value the LUTS, out of shame and fear to approach the subject in general and family medicine clinic.