What is a common cause of acute urinary retention in older men?

• A. Bladder cancer
• B. Urethral stricture
• C. Benign prostatic hyperplasia
• D. Neurogenic bladder

Answer: (C)

In older men, acute urinary retention most often results from obstruction of the prostatic urethra due to benign prostatic hyperplasia. As the prostate enlarges with age, it constricts the urethral passage, raising resistance to urine flow. The bladder has to work harder to empty, and if the detrusor muscle can’t compensate, urine suddenly can’t be expelled, causing acute retention. BPH also explains the accompanying lower urinary tract symptoms commonly seen in these patients, such as weak stream, hesitancy, and nocturia. Other causes like bladder cancer, urethral stricture, or neurogenic bladder can lead to retention but are less common in this demographic.