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General Surgery · Perioperative care: postoperative urinary retention
Sample itemA man has not passed urine 8 hours after inguinal hernia repair under spinal anaesthesia and has lower abdominal discomfort. What is the first step?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Bladder ultrasound scan followed by catheterisation if the volume is high
Spinal anaesthesia, opioids and pain commonly cause retention. A bladder scan confirms retention, and catheterisation relieves it and prevents overdistension injury.
Option by option
A. Reassurance only
Reassurance risks bladder overdistension.
B. Immediate cystoscopy
Cystoscopy is not needed at this stage.
C. Bladder ultrasound scan followed by catheterisation if the volume is high (correct)
Correct. A bladder scan with catheterisation if retained is the appropriate step.
D. Intravenous diuretics
A diuretic would worsen the retention.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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