60 yrs old male with poor stream of urine, post void residual urine is 400m1, bA hydronephrosis and prostate weighing 70 g. His urea is 120 and creat 3.5. Ideal "next immediate" step :
Catheterize with Foley catheter [Ref: Bailey and Love 25/e p1316, 1349; CSDT I 3/e p922/ "Catheterization is mandatory for acute urinary retention. Spontaneous voiding may return, but a catheter should be left indwelling.for 3 days while detruson tone returns."- CSDT I 3/e This is a case of bladder outlet obstruction most likely due to BHP (can also he due to ca). So the immediate next step is to drain the bladder a transurethral Foley catheter. If this fails suprapubic drainage can be done
Catheterize with Foley catheter
bA PC Nephrostomies
CT to rule out ca
MRI pelvis