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Postpartum Urinary Retention

Description

Nutaitis et al review postpartum urinary retention, which is relatively common following delivery. Complications are largely preventable if the condition is promptly recognized and treated. The authors are from multiple institutions in the United States.


Risk factors:

(1) epidural anesthesia

(2) operative vaginal delivery

(3) prolonged labor

(4) episiotomy

(5) neonatal macrosomia

(6) nulliparity

(7) obstetric anal sphincter injury

 

Types

Features

overt

inability to void in the 6 hours after delivery

covert

small amount of spontaneously voided urine, often with symptoms

persistent

lasts > 3 days postpartum often requiring catheterization

 

Clues to covert urinary retention:

(1) discomfort and bladder fullness over the lower abdomen

(2) voiding less than 30 mL per hour

(3) voided urine volume < 150 mL over 6 hours

 

A urinary bladder ultrasound scan can determine the volume of urine in the bladder.

 

Complications:

(1) damage to detrusor muscle

(2) damage to nerves in bladder wall

(3) bladder rupture

 


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