What is the most urgent assessment in urinary retention from benign prostatic hypertrophy?

• A. Bladder distention and discomfort
• B. Urgent decrease in urinary output
• C. Evidence of infection
• D. No symptoms

Answer: (B)

In urinary retention from benign prostatic hypertrophy, the priority is to monitor the effect on kidney function by watching urine production. A rapid decrease in urinary output is the most urgent signal because it indicates that urine isn’t being drained properly and is backing up, which can quickly lead to bladder distension and potential kidney injury if not addressed promptly. Detecting a fall in output guides immediate intervention, such as relieving the obstruction, to protect renal function. While bladder distention and discomfort are important clues and infection is a concern, neither raises as immediate a risk to the kidneys as a sudden drop in urine output.