Acute Urinary Retention and Severe Hyponatremia in a Patient With a Large Intramural Uterine Fibroid.

Acute urinary retention (AUR) is defined as the inability to pass urine voluntarily. It is more common in males, with a male-to-female incidence ratio of 13:1. In males, benign prostatic hyperplasia is the most common cause of AUR, especially in men aged above 60, whereas in females, pelvic anatomy distortion secondary to pelvic organ prolapse and pelvic masses causes most cases of AUR. Prompt diagnosis and management are the keys to avoiding complications secondary to AUR, such as pain and acute kidney injury. Less commonly, it can cause acute hyponatremia, as was seen in our patient. Hyponatremia is generally asymptomatic, but if acute and/or severe, it can cause mental status changes, seizures, and coma. Such patients need closer monitoring of their mental status and sodium level to avoid overcorrection. Here we present a unique case report of a patient with asymptomatic large uterine fibroid presented with abdominal distention who was found to have acute urinary retention with associated asymptomatic severe hyponatremia, managed conservatively.