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Postoperative Urinary Retention Differential — FRCA Final MCQ

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ModerateGeneral AnaesthesiaPostoperative Urinary Retention DifferentialFRCA Final

A 68-year-old man develops postoperative urinary retention 14 hours after spinal with heavy bupivacaine 3 mL. Motor block fully resolved. Most likely cause?

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Correct answer: D — Prostatic obstruction unmasked by fluid loading and opioids

At 14h post-spinal, pharmacological block fully resolved. Most common cause in elderly men: pre-existing BPH unmasked by perioperative fluid loading and systemic opioids (reduce detrusor contractility). CES would present with saddle anaesthesia, bilateral leg weakness, bowel dysfunction.

Reference: RCOA – 2023 – Perioperative urinary retention