After relieving acute urinary retention with catheterization, what is recommended next?

• A. Reassess for underlying cause
• B. Schedule TURP
• C. Start antibiotics
• D. Remove catheter immediately

Answer: (A)

After relieving acute urinary retention with catheterization, the priority is to reassess what caused the blockage and plan long-term management to prevent recurrence. This means taking a focused history and exam, checking for signs of infection, and evaluating how the bladder is functioning now. A digital rectal exam helps assess prostate size, a urinalysis (and culture if infection is suspected) checks for contributory infections, and a bladder scan or residual measurement shows how much urine remains after voiding. Identifying the underlying issue—most commonly benign prostatic hyperplasia in men, but also possible urethral obstruction, medication effects, or neurogenic factors—guides treatment choices. If an obstructive cause like BPH is confirmed or highly suspected, definitive therapy (such as TURP) may be considered after stabilization and initial medical management, but it isn’t the immediate next step right after catheterization. Antibiotics are reserved for confirmed infection, and removing the catheter immediately isn’t advised without a plan to assess voiding; a trial of void after catheter removal is typically staged rather than done right away.