1/8. Acute urinary retention as an unusual manifestation of aseptic meningitis.A formerly healthy 32-year-old woman was hospitalized for a closer examination of undiagnosed fever with mild headache. Despite lack of distinct findings on physical and laboratory examinations at admission, she suddenly developed anuresis due to acontractile neurogenic bladder. On the basis of her symptoms and the faint nuchal rigidity revealed later, as well as the results of cerebrospinal fluid analyses, a diagnosis of aseptic meningitis was eventually reached. While aseptic meningitis subsided within 3 weeks, about 10 weeks, including a 26-day period of anuria, was necessary for complete restoration of normal voiding function, necessitating intermittent self-catheterization. Acute urinary retention should be considered an uncommon but critical manifestation of aseptic meningitis.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/8. Acute urinary retention after use of assisted reproductive technology. A report of 2 cases.BACKGROUND: urinary retention in women is an unusual occurrence. Various conditions can cause it, including surgery, childbirth, pelvic masses, procidentia, vulva hematoma, incarceration of a gravid uterus, urologic disease, neurogenic disease and psychiatric disorders. CASES: Two infertile women underwent assisted reproductive technology (art) and luteal-phase support during which acute urinary retention occurred. The patients were evaluated by means of physical examination, urodynamic study and determination of serum progesterone levels. Bladder distention was found during luteal-phase support. Urodynamic studies revealed detrusor areflexia. Serial serum progesterone levels were > 100 ng/mL. CONCLUSION: Cases of acute urine retention during luteal-phase support are rarely reported. urine retention should be considered in the differential diagnosis when abdominal pain occurs after patients undergo art. Transient elevation of the progesterone level may be the cause of the acute urine retention.- - - - - - - - - - ranking = 10.301296883085keywords = physical examination, physical (Clic here for more details about this article) |
3/8. Gastrointestinal stromal tumor of the prostate.We present a unique case of an atypical prostate tumor in a 49-year-old man with acute urinary retention. digital rectal examination revealed a large prostate with a parenchymal mass on the left side. Radiologic imaging showed a 14.2 x 9.6 x 14.0-cm prostatic mass and multiple liver metastases. A pathologic diagnosis of a prostatic gastrointestinal stromal tumor was made and was confirmed by molecular analysis. Therapy consisted of a tyrosine kinase inhibitor, resulting in prostate mass reduction. After 100 weeks, the patient was in good physical condition with a continuing partial response with a reduced mass volume and liver nodules.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/8. Paraurethral leiomyoma in a female causing urinary obstruction.We report a case of paraurethral leiomyoma in a female patient, in which the first symptoms were dysuria and sensation of incomplete voiding. The physical examination revealed a mass in the anterior vaginal wall. The diagnosis was made through ultrasonography and pelvic MRI and confirmed by transvaginal ultrasound-guided needle biopsy. The surgical excision was accomplished without opening the urinary tract. A review of the relevant published studies and a suggestion for the appropriate management of these cases are included.- - - - - - - - - - ranking = 10.301296883085keywords = physical examination, physical (Clic here for more details about this article) |
5/8. Cystocerebral syndrome. Acute urinary retention presenting as confusion in elderly patients.The diagnosis of acute mental status changes in the elderly patient is often very difficult. Many causes are possible, and there is often little history obtainable. The physical examination occasionally provides the essential clues needed to discover the source of the sudden deterioration. We have recently evaluated four episodes of acute delirium in three elderly patients who presented with no readily apparent cause for these changes. On further evaluation, the patients were found to have marked bladder distention associated with acute urinary retention. None of these patients complained of discomfort, and none had any awareness or recollection of their deterioration. Each patient had rapid resolution of symptoms on bladder decompression. To our knowledge, this "cystocerebral syndrome" has not been previously described, and we suggest that it be considered in the evaluation of acute confusional states in elderly men.- - - - - - - - - - ranking = 10.301296883085keywords = physical examination, physical (Clic here for more details about this article) |
6/8. Of fat and fascia: clinical conundrum corner.A case report involving a 76-year-old male is presented. The signs and symptoms represent a difficult diagnostic problem. The physical signs are dependent on a knowledge of the distribution of fat and fascia in the region involved. The importance of this distribution, both physiologic and pathologic, is the subject of a brief commentary.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
7/8. Acute urinary retention: an unusual presentation of appendiceal abscess.Emergency physicians frequently encounter patients with acute urinary retention. Although most common among the elderly, pediatric and young adult patients occasionally may present with this complaint. The differential diagnosis and emergency department work-up must be age specific. We discuss the case of a young man who presented with acute urinary retention, subsequently found to be caused by undiagnosed appendicitis with appendiceal abscess formation. Only nine such cases have been reported in the literature thus far, with only one occurring in the nonpediatric population. This case represents the second such case to be reported. The importance of a thorough history, physical examination, and diagnostic work-up of patients who present with acute urinary retention, particularly those in the younger age group, is emphasized.- - - - - - - - - - ranking = 10.301296883085keywords = physical examination, physical (Clic here for more details about this article) |
8/8. Neuropathic urinary retention in the absence of neurological signs.We present two cases of painless urinary retention secondary to central intervertebral disc prolapse. In neither case were there signs or symptoms suggesting an underlying neurological insult. Both patients voided spontaneously following neurosurgical intervention. The classical features of acute cauda equina compression may be absent in patients with central lumbar disc protrusion. Painless urinary retention may be the only physical sign.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |