Last reviewed 01/2018

The first objective is to relieve the patient of the discomfort so provide some strong opiate analgesia. Try conservative methods first - privacy, sound of running water, and making the patient stand up.

Catheterise if these conservative methods do not provide relief. First, try a Foley catheter inserted via the urethra; if unsuccessful, try a suprapubic catheter.

Some factors that should discourage an attempt at simple urethral catherisation include:

  • previous prostatectomy
  • known urethral stricture
  • history of difficult catheterisation
  • non-retractile foreskin

NICE have suggested guidance regarding the management of acute urinary retention in an adult male (1):

  • immediately catheterise men with acute retention
  • offer an alpha blocker to men for managing acute urinary retention before removal of the catheter