Abstract
Urinary retention is a urological emergency that can lead to serious complications if left untreated. Although rare, risperidone has been associated with urinary retention through anticholinergic effects and modulation of dopaminergic and serotonergic pathways, which can inhibit detrusor muscle contractility and increase urethral sphincter activity. This report presents the case of a 54-year-old male patient who experienced multiple episodes of urinary retention that resulted in gross hematuria, hydronephrosis, and hospital admissions; this was considered to be caused by risperidone, which he was taking for bipolar disorder. This case highlights the importance of considering medication side effects in patients with recurrent urological issues, particularly those with multiple comorbidities. By contributing to the limited literature on risperidone-induced urinary retention, this report aims to enhance clinical awareness and guide decision-making in similar presentations.