Day 113: Retention to Relief

...more specifically, urinary retention. Today, I had a very interesting patient case. He's a 21 year old, Afghan Army soldier who had been able to urinate for over 12 hours. He came to the clinic complaining of excruciating suprapubic pain along with an insatiable urge to pee:( Poor guy! After discussing the case and reviewing the history with the medical officer on call, we went ahead and attempted a foley catheter placement to empty out his bladder...multiple times.

You are all probably wondering what can cause this problem...I'm no urologist, but I could come up with a few possible causes for his issue. Foreign body (ouch!), drugs (Decongestants are notorious), or meatal/urethral stenosis (small caliber "plumbing"). Large prostates can also be the culprit, but not in 21 year old males so I spared him the rectal exam. Lucky me!


After discussing the possibilities with the duty officer, we went ahead and did a physical exam (PE's are an uncommon occurrence with the Afghan docs). I'll spare you the pictures, but what I found was a very narrow meatus (pee pee hole) which made it near impossible for me to place any of the catheters we had available (they were all too large in diameter). We ended up sending him to a nearby US hospital who had the equipment for this type of issue. As you can see from the picture above, he was good-to-go in no time! Today, we transferred him to Kabul to see the urologist. Hopefully, they will offer him some permanent relief...

"Comfort, yes, comfort My people!
Says your God." Isaiah 40:1 NKJV