Postpartum urinary retention: what are the sequelae? A long-term study and review of the literature.

Mohr, Stefan; Raio, Luigi; Gobrecht-Keller, Ursula; Imboden, Sara; Mueller, Michael D; Kuhn, Annette (2022). Postpartum urinary retention: what are the sequelae? A long-term study and review of the literature. International urogynecology journal, 33(6), pp. 1601-1608. Springer 10.1007/s00192-021-05074-5

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INTRODUCTION AND HYPOTHESIS

Postpartum urinary retention (PUR) may cause long-term urogenital tract morbidity. The incidence ranges from 0.18 to 14.6%, but the importance of prompt diagnosis and appropriate management is often underappreciated. The paucity of data on long-term outcome after PUR contributes to these drawbacks. The aim of this study was to assess long-term persistence of elevated PVR (post-void residual urine) volume after PUR. Pathophysiology, risk factors and management of PUR are reviewed.

METHODS

In our tertiary referral urogynecology unit in the University Women's Hospital of Bern, Switzerland, all patients who were referred for PUR were asked to participate in this study. PVR was measured sonographically every 2 days until day 15, then after 6, 12, 24 and 36 months and, if increased, the patients were instructed to perform clean intermittent self-catheterization. If retention persisted longer than the lactation period, multichannel urodynamics was performed.

RESULTS

Sixty-two patients were included. The median PVR normalized at day 7. Long-term voiding disorders were found in 8.2%, 6.7%, and 4.9% after 1, 2, and 3 years respectively. Multichannel urodynamics confirmed in all patients with persisting retention an acontractile detrusor and de novo stress urinary incontinence in 4 cases. Quantile regression did not reveal any factor contributing to earlier recovery. Eighty-nine percent of the patients with PUR had operative vaginal deliveries, emphasizing the importance of this risk factor for PUR.

CONCLUSIONS

In most cases PUR resolves early, but voiding difficulties persist more often than previously thought, and for these patients the consequences are devastating. Obstetric awareness, early active management, and developing management strategies in the postpartum period might preclude lower urinary tract morbidity.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Gynaecology

UniBE Contributor:

Mohr, Stefan, Raio, Luigi, Imboden, Sara, Mueller, Michael, Kuhn, Annette

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0937-3462

Publisher:

Springer

Language:

English

Submitter:

Monika Zehr

Date Deposited:

11 Jan 2023 17:19

Last Modified:

11 Jan 2023 23:23

Publisher DOI:

10.1007/s00192-021-05074-5

PubMed ID:

35129645

Uncontrolled Keywords:

Covert urinary retention Overt urinary retention Post-void residual volume Postpartum urinary retention Residual urine Voiding problems

BORIS DOI:

10.48350/176831

URI:

https://boris.unibe.ch/id/eprint/176831

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