Early postpartum voiding dysfunction: incidence and correlation with obstetric parameters.
OBJECTIVE
To investigate the incidence and obstetric risk factors in early postpartum voiding dysfunction.


METHODS
Two hundred seventy-seven consecutive women in the early postpartum period were prospectively enrolled. Evaluation included history, physical examination, urinary questionnaire and non-invasive uroflowmetry measurements. Patients were interviewed regarding the presence and severity of voiding symptoms and were categorized into symptomatic versus asymptomatic subgroups. Obstetric parameters were compared in symptomatic versus asymptomatic patients as well as in cases of decreased (< 15 mL/sec) versus normal maximum urinary flow rates.


RESULTS
One hundred twenty-five women (45% of the study population) hadearly postpartum voiding difficulties. Symptoms were significantly more common after vacuum extraction (38%) than spontaneous vaginal delivery (27%) or cesarean section (15%). The second stage of labor was significantly prolonged in symptomatic versus asymptomatic patients (62+/-52 versus 47+/-48 minutes). Voided volume, maximum and average flow rates and continuous flow pattern were significantly decreased in symptomatic versus asymptomatic patients. Twenty-eight patients (10%) demonstrated decreased (<15 mL/sec) maximum flow rates. The first stage of labor was significantly prolonged in these patients (9.7+/-5.8 versus 6.4+/-3.9 hours). Twenty-five patients (13%) gave birth to a neonate weighing > or =3,800 g. Maximum flow rates among these women were significantly decreased as compared to women with smaller infants (25.6+/-11 versus 32.9+/-19.2 mL/sec, respectively).


CONCLUSIONS
Approximately 50% of patients complained of voiding difficulties in the immediate postpartum period. Main risk factors were prolonged first and second stages of labor, vacuum extraction and birth weight > or = 3,800 g. Long-term follow-up is needed to determine the significance of this clinically common entity.
Groutz
Asnat
A
Department of Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv, Israel. agroutz@yahoo.com
Hadi
Efrat
E
Wolf
Yoram
Y
Maslovitz
Sharon
S
Gold
Ronen
R
Lessing
Joseph B
JB
Gordon
David
D
D000328:Adult; D001724:Birth Weight; D005260:Female; D006801:Humans; D015994:Incidence; D007744:Obstetric Labor Complications; D049590:Postpartum Period; D011247:Pregnancy; D011446:Prospective Studies; D011644:Puerperal Disorders / Q000453:epidemiology; D012307:Risk Factors; D014555:Urination Disorders / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D014563:Urodynamics; D014620:Vacuum Extraction, Obstetrical / Q000009:adverse effects