Background Urinary retention is one of the common urologic emergencies constituting a significant workload of urologists and non-urologists alike. This study was on ‘‘Urinary Retention in Adult Male Patients at Aminu Kano Teaching Hospital (AKTH), Kano – Causes and Outcome of Management’’. It was undertaken to identify the causes of urinary retention in adult male patients at AKTH, Kano, and determine the outcome of their management. Methods: It was a prospective hospital-based study of 118 consecutive adult male patients who presented to Aminu Kano Teaching Hospital, Kano with urinary retention. The study duration was 12 months (January to December 2012). On presentation, a brief history was taken and rapid physical examination done; the urinary retention was relieved by either urethral catheterization or suprapubic cystostomy. Where patients had complications such as dehydration, anaemia, sepsis or renal impairment, they were resuscitated. Haemodialysis was done in patients who had indications such as pulmonary oedema, uraemic pericarditis and uraemic encephalopathy or biochemical derangement such as grossly abnormal serum urea, electrolytes and creatinine. A detailed history on duration of the retention, presence of preceding lower urinary tract symptoms, predisposing factors such as past history of urethritis and childhood terminal haematuria, precipitating factors such as urogenital trauma, urinary tract infection, haematuria, and complications associated with urinary retention were obtained. Patients were examined with emphasis on general physical examination, abdominal, perineal and digital rectal examination and neurologic system examination. Patients in whom urinary retention was due to benign prostatic hyperplasia were started on medical therapy with Tabs tamsulosin 0.4mg daily and Tabs dutasteride 0.5mg daily. The catheter was removed after 3 days of commencement of the drugs for trial of micturition (trial without catheter). Packed cell volume, serum urea, electrolytes and creatinine, urinalysis, urine microscopy, culture and sensitivity, and abdominal ultrasound were done on the patients. Other investigations such as serum prostate specific antigen, retrograde urethrogram (with or without micturating cystourethrogram), and urethrocystoscopy were individualized based on the clinical indications. The investigations results were reviewed in the ward for in-patients and in the urology out-patient clinic during follow-up for out-patients. Each patient was followed up for a minimum of 6 months during which investigations results were reviewed and the success of trial without catheter was assessed. From the results of the investigations, definitive diagnosis of causes of the urinary retention were made and presence of complications confirmed. Data were entered into the computer and analysed using SPSS Version 16. Results: Data for one hundred and ten (110) patients were analysed (the remaining eight patients were lost to follow-up). They ranged from 17 to100 years of age, with a mean age of 56 ±19.3 SD years. Patients within the age range of 60-79 years accounted for the largest group (27.3% (60-69years) +21.8% (70-79years) = 49.1%). Patients within the ages of 20 - 29 years accounted for 12.7%. The much older age group (≥ 90 years) and the younger (≤ 20 years) had the lowest rate of developing urinary retention. The most common cause of urinary retention in this study was benign prostatic hyperplasia (51.8% of the patients). This was followed by urethral stricture (20%), cancer of the prostate (7.3%), urethral injury (7.3%), bladder tumour (6.4%), and bladder/urethral stone (1.8%). Both benign prostatic hyperplasia and urethral stricture co-existed in 3.6% of the patients. More than one half of the patients (53.4%) presented with acute urinary retention, 30.5% presented with chronic urinary retention, and 16.1% were diagnosed to have acute-on-chronic urinary retention. Patients were evaluated for complications associated with the urinary retention at presentation. The complications found were: urinary tract infection (in 24.5% of patients), renal impairment (14.5%), and anaemia (11.8%). All the complications were seen in patients with chronic and acute-on-chronic urinary retention. In 67 patients (61.0%), the retention was successfully relieved by urethral catheterization, while in the remaining 43(39.0%) it was relieved by suprapubic cystostomy. The most common complication following catheterization noted in this study was introduction of urinary tract infection (17.3%) followed by haematuria (5.5%) and urethral injury (2.7%). None had post obstructive diuresis. Successful trial without catheter defined as ability to empty the urinary bladder with mild or no lower urinary tract symptoms (international prostate symptoms score of 0 to 8) was recorded in 71.4% of the patients. Conclusion: Urinary retention is commoner among the middle aged and the elderly. Benign prostatic hyperplasia remains the leading cause of urinary retention, but urethral stricture, prostate cancer and bladder tumour are still important causes. Acute urinary retention was the commonest type of urinary retention; however, complications due to the retention were associated with chronic and acute-on-chronic urinary retention. Most patients (more than 70%) with urinary retention from benign prostatic hyperplasia did well on medical management.