Differential Diagnosis for a 65-year-old Male with Urinary Retention
Single Most Likely Diagnosis
- Benign Prostatic Hyperplasia (BPH): This is the most common cause of urinary retention in older men. The enlarged prostate gland can compress the urethra, leading to obstruction of urine flow.
Other Likely Diagnoses
- Urinary Tract Infection (UTI): UTIs can cause urinary retention, especially in older adults, due to inflammation and irritation of the bladder and urethra.
- Neurogenic Bladder: Conditions such as diabetes, stroke, or spinal cord injury can damage the nerves that control bladder function, leading to urinary retention.
- Medication Side Effects: Certain medications, such as anticholinergics, antihistamines, and decongestants, can cause urinary retention as a side effect.
- Constipation: Severe constipation can put pressure on the urethra, leading to urinary retention.
Do Not Miss Diagnoses
- Spinal Cord Compression: Cauda equina syndrome or spinal cord compression can cause sudden onset of urinary retention and is a medical emergency.
- Bladder Outlet Obstruction: Obstruction due to bladder stones, blood clots, or tumors can cause urinary retention and requires prompt attention.
- Acute Kidney Injury: Urinary retention can lead to acute kidney injury if not promptly relieved, making it essential to address the underlying cause.
Rare Diagnoses
- Prostate Cancer: Although less common than BPH, prostate cancer can also cause urinary retention due to obstruction of the urethra.
- Urethral Stricture: Narrowing of the urethra due to injury, infection, or inflammation can cause urinary retention.
- Bladder Neck Contracture: Scarring at the bladder neck can cause obstruction and urinary retention.
- Neurological Disorders: Conditions such as multiple sclerosis, Parkinson's disease, or peripheral neuropathy can affect bladder function and cause urinary retention.