A 75-year-old male patient was admitted to the emergency department with difficulty voiding. He had this complaint for over a year, and tonight, although he felt pain and distention in his lower abdomen, he could not urinate at all. On his physical exam, the patient had a palpable mass that was thought to be the distended bladder. He was agitated and tachycardic. He was diagnosed with acute urinary retention, and initial attempt to insert urinary indwelling catheter was failed. The second attempt with a Coude catheter was successful and 2 liters of urine was drained gradually. His rectal exam revealed prostate enlargement. He was discharged with instructions, uneventfully.