Acute urinary retention is the sudden inability to micturate; it is usually painful and requires treatment with a urinary catheter.1 Risk factors are increasing age, especially in men; urological conditions such as benign prostatic hyperplasia, prostate cancer, and urethral stricture; medical conditions such as constipation and diabetes mellitus; bed rest; surgery; and the use of certain drugs.2 Its incidence in the general population has mostly been studied in men, and it varies between 2.2 and 6.8 per 1000 person years. Acute urinary retention is generally treated immediately with a urinary catheter. After the acute period, most men will be offered a trial without catheter, often in combination with α adrenergic blockers. Prostate surgery will be considered if this trial fails.34567

Few data are available on mortality in patients with acute urinary retention. A retrospective cohort study in this week’s BMJ by Armitage and colleagues is the first to study …