Acute Urinary Retention Secondary to a Large Uterine Fibroid in a Nulliparous Patient: A Case Report

Abstract

Background: Acute urinary retention in women is an uncommon urological emergency, and uterine fibroids are a rare but important obstructive cause. Large or impacted fibroids may compress the bladder neck and proximal urethra, leading to bladder outlet obstruction and urinary retention requiring prompt diagnosis and management. Aim: To highlight the significance of comprehensive evaluation of a woman of reproductive age who presents with acute urinary retention. Case Presentation: We present a 40-year-old nulliparous woman with a history of recurrent pregnancy losses who presented with acute urinary retention secondary to a large uterine fibroid. Discussion: Uterine fibroids remain a rare cause of acute urinary retention, especially when impacted, causing anterior and superior displacement of the cervix with subsequent compression of the bladder neck and superior urethra, or when it causes compression of the pelvic nerve plexus leading to weak contraction of the detrusor muscle. Urethral catheterisation provides immediate symptom relief, but definitive measures include myomectomy and hysterectomy depending on desire for future childbearing. Conclusion: Physicians should therefore maintain a high index of suspicion in reproductive age women who present with a pelvic mass and urinary symptoms, especially in the absence of heavy menstrual bleeding.