The impact of anesthesia and mode of delivery on the urinary bladder in the postdelivery period.
OBJECTIVE
To evaluate the effect of regional anesthesia and mode of delivery on the function of the urinary bladder. The primary outcome was the time taken for urinary bladder sensation to return following various modes of delivery and analgesia/anesthesia. The secondary outcome was the volume of urine present in the bladder when sensation returned.


METHODS
The study was conducted at the Birmingham Women's Foundation Trust, Birmingham, UK. A total of 120 postnatal patients were studied between January 2007 and March 2008. The volume of urine in the bladder when sensation first returned was measured by release of a clamp for women fitted with an indwelling catheter, and/or estimated using ultrasound.


RESULTS
The median times for sensation to return to the bladder in patients who had a vaginal delivery without epidural analgesia, vaginal delivery with epidural analgesia, and after elective cesarean delivery under spinal anesthesia were 122 minutes (IQR, 112-136 minutes), 234 minutes (IQR, 202-291 minutes), and 374 minutes (IQR, 311-425 minutes), respectively. The median urine volumes were 144 mL (IQR, 112-192 mL), 200 mL (IQR, 136-336 mL), and 152.5 mL (IQR, 125-270 mL), respectively.


CONCLUSIONS
These results should be taken into consideration when formulating a postdelivery bladder care protocol.
Foon
Richard
R
Department of Obstetrics and Gynecology, Southmead Hospital, Westbury on Trym, Bristol, UK. r.p.foon@talk21.com
Toozs-Hobson
Philip
P
Millns
Peter
P
Kilby
Mark
M
D015360:Analgesia, Epidural / Q000009:adverse effects; D000773:Anesthesia, Obstetrical / Q000009:adverse effects*; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D016022:Case-Control Studies; D002585:Cesarean Section / Q000009:adverse effects*; D005260:Female; D006801:Humans; D009321:Natural Childbirth; D011247:Pregnancy; D012677:Sensation / Q000187:drug effects*; D014463:Ultrasonography; D001743:Urinary Bladder / Q000000981:diagnostic imaging / Q000502:physiology; D001745:Urinary Bladder Diseases / Q000209:etiology; D014554:Urination / Q000187:drug effects*; D055815:Young Adult