An 82-year-old with constipation develops frequency, nocturia and overflow leakage. Post-void residual is 620 mL, rectum is loaded, prostate is

Question

An 82-year-old with constipation develops frequency, nocturia and overflow leakage. Post-void residual is 620 mL, rectum is loaded, prostate is enlarged and creatinine has risen from 92 to 138 micromol/L. What is the immediate integrated plan?

Accepted Answer

Catheterise, clear faecal loading and assess outlet obstruction

Answer

Start tamsulosin and defer catheterisation while monitoring the residual

Answer

Catheterise and add oxybutynin once the residual falls below 200 mL

Answer

Catheterise and prescribe antibiotics because retention with AKI implies infection

Answer

Clear faecal loading first and repeat the residual and creatinine tomorrow

Overflow incontinence from retention and constipation — SCE Geriatric Medicine MCQ

An 82-year-old with constipation develops frequency, nocturia and overflow leakage. Post-void residual is 620 mL, rectum is loaded, prostate is enlarged and creatinine has risen from 92 to 138 micromol/L. What is the immediate integrated plan?