Abstract Purpose We describe the use of an alternative catheter for clot irrigation. Materials and Methods Six patients with severe clot retention that could not be treated successfully with irrigation using large bore urethral catheters were subsequently treated with a fenestrated 28 to 32F Rusch red rubber rectal catheter. Results All clots were successfully evacuated. Cystoscopic evaluation the following day in 4 patients with hematuria confirmed the absence of clots. The other 2 patients did not undergo cystoscopy but continuous bladder irrigation was completely clear for the next 24 hours and the catheters were removed without further sequelae. Conclusions Irrigation through a rectal tube can provide immediate relief of clot retention and consequently avoid emergency endoscopic intervention in the operating room.