Urinary retention Quiz: Ace Your Exams
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A 35-year-old man presents to the emergency department for evaluation of acute urinary retention and low back pain. The patient was performing dead-lifts at the gym when he felt the weight was too heavy and suddenly fell backwards to the floor. He has since had right low back and flank pain. The patient went home and took several analgesics but became increasingly concerned when he was unable to urinate. Past medical history is unremarkable. Temperature is 37°C (98.6°F), blood pressure is 167/65 mm Hg, heart rate is 99/min, respiratory rate is 18/min, and oxygen saturation is 96% on room air. On physical examination the patient appears uncomfortable. Abdominal exam is significant for suprapubic fullness. The patient has no step offs or deformities overlying the lumbar spine. The patient is unable to ambulate due to pain and weakness in the legs. Bladder scan reveals >1L. Which of the following additional findings would most likely be present?
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