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My husband, who has moderate to severe dementia, is urinating less frequently than usual while his water intake is normal. I fear he is retaining urine. The hospice RN said the doc could do a rectal exam to check if his prostate is enlarged but that would be a nuclear war. My husband does not even like me to change his diapers anymore, so there is no way he’d let a stranger to probe his rectum. Is there another way to check his prostate?

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If his prostate is enlarged, it would cause his bladder to be distended. It would not cause his circulatory system to retain fluid. If he is retaining water systemically, then he would not have as much fluid to pee out. Unless you are actually measuring his fluid intake, and his urine output, you would not actually know. Since he is incontinent, you would weigh his diapers when dry and then when wet. And measure his fluid intake as he drinks and write it down. You could also weigh him daily to see if he is gaining weight from fluid retention. He could be given meds to help urine fluid if there is concern that flow is blocked. But first he may want to see how fluid he is drinking. Prostate surgery would require him to be off hospice so maybe start with the simpler intake and output measurements first.
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Worriedspouse, have you discussed with his doc if maybe giving him a sedative would be effective enough to allow to check him?
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An ultrasound after voiding, which is simple as a sort of microphone looking gadget passed over the bladder is a simple way to do this and non-invasive.
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Tothill Feb 2020
At my hospital they often have to do an internal rectal prostrate US. OP's hubby would not allow that.

Worriedspouse, it is time to have a conversation your husband's doctor. First to rule out other reasons he may not be peeing as much. What would you do if he does have prostrate cancer? Treat it or leave it be? If you would not treat it then perhaps Hospice in on the horizon.
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Psa125 I think is the blood test that checks for prostrate problems. Talk to his doctor.

Can you check his ankles for water retention? It could very well be that he is utilizing more water and not a problem.

I would talk to his doctor about how to make sure that he is all okay. They will know what is available for testing.

My dad was put on a low dose prostrate cancer drug, no cancer. But it helped him empty his bladder and he no longer has incontinence.
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