Differential Diagnosis for Urinary Retention in a 50-year-old Female
Single Most Likely Diagnosis
- Pelvic Organ Prolapse: This condition is common in postmenopausal women and can cause urinary retention due to the prolapse of the pelvic organs, which can put pressure on the urethra.
Other Likely Diagnoses
- Urinary Tract Infection (UTI): A UTI can cause urinary retention, especially if the infection has spread to the upper urinary tract or if there is significant inflammation.
- Neurogenic Bladder: Conditions such as diabetes, stroke, or spinal cord injury can cause neurogenic bladder, leading to urinary retention.
- Medication Side Effects: Certain medications, such as anticholinergics, can cause urinary retention as a side effect.
- Constipation: Severe constipation can cause urinary retention due to the pressure on the urethra.
Do Not Miss Diagnoses
- Cauda Equina Syndrome: A rare but serious condition where the nerves in the spinal cord are compressed, causing urinary retention, among other symptoms. If missed, it can lead to permanent nerve damage.
- Spinal Cord Injury: Trauma to the spine can cause urinary retention, and it is crucial to identify and treat promptly to prevent long-term damage.
- Ovarian Torsion: Although rare, ovarian torsion can cause urinary retention due to the severe pain and pressure on the surrounding structures.
Rare Diagnoses
- Urethral Stricture: A narrowing of the urethra, which can cause urinary retention. This is more common in men but can occur in women, especially after trauma or instrumentation.
- Mullerian Duct Anomalies: Congenital anomalies of the female reproductive tract can cause urinary retention, although this is rare and usually diagnosed earlier in life.
- Sacral Nerve Root Compression: Compression of the sacral nerve roots can cause urinary retention, although this is a rare condition.