A 62 year-old male with no significant medical history, presented to the emergency department with several days of vomiting. Examination showed suprapubic fullness with tenderness to palpation and a bedside ultrasound was performed:
Right upper quadrant ultrasound with moderate hydronephrosis.
Left upper quadrant ultrasound with moderate hydronephrosis.
Relatively non-distended bladder.
Post-void bladder volume.
Ultrasound revealed moderate bilateral hydronephrosis with a relatively non-distended bladder. Labs were notable for new renal failure and the patient was admitted for continued evaluation. He was ultimately diagnosed with idiopathic retroperitoneal fibrosis with bilateral distal ureteral obstruction requiring stenting.
Anatomy of Acute Urinary Retention:
Differential Diagnosis of Acute Urinary Retention:1,2,3