Differential Diagnosis for Hematuria Resulting in Clots and Acute Urinary Retention
Single Most Likely Diagnosis
- Benign Prostatic Hyperplasia (BPH): This condition is common in older males and can cause urinary retention due to obstruction. Hematuria and clot formation can occur, especially if there's an associated urinary tract infection or bladder outlet obstruction.
Other Likely Diagnoses
- Bladder Cancer: A possible cause of hematuria, and if the tumor is large enough, it can cause urinary retention. Clots can form due to the tumor's disruption of the bladder lining.
- Kidney Stones: Large stones can cause severe pain, hematuria, and if they obstruct the urethra, acute urinary retention. Clots may form if the stone causes significant bleeding.
- Prostate Cancer: Similar to BPH, prostate cancer can cause urinary retention and hematuria, especially if the cancer is advanced and obstructing the urethra.
Do Not Miss Diagnoses
- Trauma: Any form of pelvic or genital trauma can cause hematuria and urinary retention. It's crucial to consider trauma, especially if the patient has a history of recent injury.
- Sepsis: Although less common, sepsis due to a urinary tract infection can cause acute urinary retention and hematuria. Early recognition is vital due to the high mortality rate associated with sepsis.
Rare Diagnoses
- Arteriovenous Malformation (AVM): A rare vascular anomaly that can cause hematuria and clot formation. It's essential to consider AVM in cases where no other obvious cause is found.
- Bleeding Disorders: Conditions like hemophilia can increase the risk of bleeding and clot formation in the urinary tract, leading to hematuria and urinary retention.
- Schistosomiasis: A parasitic infection that can cause bladder damage, leading to hematuria and urinary retention. This diagnosis should be considered in patients with a history of travel to endemic areas.