Postpartum voiding dysfunction

Abstract

Key content:• The postpartum bladder is vulnerable to urinary retention; if undetected, this can lead to bladder underactivity, recurrent urinary tract infection and incontinence.• The aim of intrapartum bladder care is to prevent bladder overdistension.• Following delivery or catheter removal, no woman should be allowed to go longer than 6 hours without voiding.• All units should have a guideline for bladder care and the management of postpartum voiding dysfunction. Learning objectives:• To be aware of the risk factors for the development of postpartum voiding dysfunction and the symptoms indicating voiding problems.• To learn about the management of postpartum voiding dysfunction. Ethical issues:• Is it acceptable to catheterise a woman to estimate the volume of residual urine when this can be estimated by ultrasound scanning of the bladder?Keywords intermittent self catheterisation / postpartum urinary retention / postvoid residual urine volume

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“…Urine residues was collected in urine bag to measure urine volume. If the residual urine volume was >200 ml, Vol 6,No 4 October 2018…”

“…Epidural anaesthesia may also decrease or exclude sensations of urgency from the need for urination during labour and the postpartum period. [3][4][5][6][7] Inaccuracies or delays in diagnosis and management of PUR can cause excessive distension of the bladder, detrusor muscle damage, and increase risk of urinary tract infections, long-term voiding dysfunction and renal injury. 3 Prostaglandin (PGS) is essential to improve detrusor muscle contraction.…”

Postpartum voiding dysfunction

“…I read the article on postpartum voiding dysfunction with great interest 1 . It was a very useful work on a common problem encountered in the labour ward.…”

Author's reply

“…Dear Sir I read the article on postpartum voiding dysfunction with great interest. 1 It was a very useful work on a common problem encountered in the labour ward. I felt another important issue worth stressing in the management of voiding dysfunction is identifying occult haematoma that is causing retention without any obvious symptoms other than retention.…”

“…Although haematuria and hypotension have been reported, these are rarely of clinical significance. 1…”