Case history:
A 70-year-old female underwent placement of a morphine Prometra IPP (Flowonix, Mt. Olive, NJ) for chronic peripheral neuropathy. The IPP was implanted by her pain management specialist. The patient’s history was significant for chronic pain syndrome, peripheral vascular disease, prior cerebrovascular accident with no residual deficits, hypertensive disorder, 10-year history of type II diabetes, and spastic pelvic floor muscles. At the time of symptom onset, the patient had no history of urinary retention, voiding dysfunction, pelvic organ prolapse, or urinary incontinence.
The patient initially presented to urogynecology 4 days after morphine IPP placement complaining that she was “unable to void without assistance.” Urinalysis and urine culture were negative for infection. Voided volumes were less than 100 cc. Her postvoid residual volumes (PVRs) were approximately 600 cc, consistent with acute urinary retention.