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Urinary retention with overflow incontinence — DGM MCQ

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HardContinenceUrinary retention with overflow incontinenceDGM

An 88-year-old man in a care home has new urinary incontinence and agitation. He has benign prostatic enlargement, diabetes and takes amitriptyline. Bladder scan after voiding shows 620 mL residual urine and creatinine has risen from 95 to 180 micromol/L. What is the most appropriate assessment?

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Correct answer: A — Post-void residual assessment with urgent evaluation for retention and renal impairment

The large residual volume with AKI suggests urinary retention with overflow and needs urgent evaluation. A bladder diary is useful in stable lower urinary tract symptoms but is not enough here. Antimuscarinics could worsen retention and confusion.

Reference: NICE CG97; BNF