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Sonographic Findings of Acute Urinary Retention Secondary to an Impacted Pelvic Mass

Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei Medical University, Taipei, Taiwan, Republic of China (J.-M.Y.); and Department of Obstetrics and Gynecology, Cathay General Hospital, Taipei, Taiwan, Republic of China (W.-C.H.).

Address correspondence and reprint requests to Jenn-Ming Yang, MD, Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, 92 Chung-Shan N Rd, Section 2, Taipei 104, Taiwan, Republic of China.

Objective. To describe the sonographic findings in a series of cases of acute urinary retention due to an impacted pelvic mass. Methods. The anatomic changes of the lower urinary tract in 6 patients with impacted pelvic masses and acute urinary retention (3 cases of an impacted uterine leiomyoma and 3 cases of a retroverted gravid uterus) were evaluated with transabdominal and transvaginal sonography. Results. When patients were in the supine position, the impacted pelvic masses displaced the cervix superiorly and anteriorly, compressing the lower bladder, leading to obstruction of the internal urethral orifice. During straining, there was no limitation of urethral mobility, but the increased abdominal pressure further compressed the lower bladder. When the subjects stood, the lower bladder filled with urine. There was descent of the bladder neck, and obstruction was relieved. Conclusions. Acute urinary retention in cases of an impacted pelvic mass is caused by a displaced cervix compressing the lower bladder, obstructing the internal urethral orifice. The urethra itself is not compressed or distorted.

Key Words: impacted pelvic mass • sonography • urinary retention

Abbreviations: TAS, transabdominal sonography • TVS, transvaginal sonography

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