Undocumented UroLume Stent Presenting Years Later With Acute Urinary Retention and Infection in a Patient With Dementia.

An 87-year-old male with dementia was admitted to the behavioral health unit for behavioral disturbances, including increased confusion, agitation - especially when taking medications - daytime somnolence with nighttime wakefulness, and disorientation. He rapidly deteriorated, becoming nonverbal and unresponsive to questions, due to urinary retention and infection caused by a retained UroLume stent placed approximately 30 years earlier. Despite stable vitals and a normal white blood cell count just days prior, his WBC acutely rose to 27,000 cells/mm3, prompting urgent urological intervention. The evaluation also revealed an undocumented artificial urinary sphincter (AUS), which further contributed to urinary retention and complicated management. This case emphasizes the importance of thorough history-taking, physical exams, and awareness of outdated implants, as the absence of documentation regarding both the UroLume stent and AUS in this 87-year-old patient significantly delayed diagnosis and treatment. It also highlights the need for meticulous clinical evaluation in elderly patients presenting with altered mental status.