Which of the following patients is at risk for urinary retention after surgery?

Women with multiple pregnancies are at an increased risk for urinary retention after surgery primarily due to pelvic floor changes that occur during pregnancy and childbirth. These changes can lead to weakened pelvic muscles and potential nerve damage, both of which may affect the urinary system and obstruct normal bladder function.

In the perioperative setting, anesthesia, particularly spinal or epidural anesthesia, can also contribute to urinary retention by inhibiting the bladder's ability to contract and empty effectively. Given that women who have gone through multiple pregnancies may already have compromised pelvic support, the addition of surgical intervention further elevates their risk for urinary retention.

While other patient scenarios may involve specific risks related to surgical procedures, they do not have the same direct connection to urinary function as the physiological changes faced by women with multiple pregnancies.