Two men presented at the Accident & Emergency Department with lower urinary tract symptoms. The first patient was a 76-year-old male with reddish urine and lower abdominal pain. A CT-scan revealed a tumorous mass related to the bladder. The second patient was a 61-year-old male with dysuria and lower abdominal pain. In both patients the complaints were due to a rectus sheath haematoma. Rectus sheath haematoma is a rare condition caused by damage of the epigastric vessels or a rupture of the rectus abdominis muscle. Voiding problems can arise when the haematoma extends into the prevesical (Retzius) space that is anatomically related to the rectus sheath. A haematoma of the rectus sheath is difficult to diagnose. Current insights show that conservative treatment is generally sufficient.
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