Protracted postpartum urinary retention: the importance of early diagnosis and timely intervention.
OBJECTIVE
To evaluate the prevalence and obstetric risk factors of protracted postpartum urinary retention, beyond the third postpartum day.


METHODS
Thirty thousand seven hundred fifty-seven consecutive women delivered in Lis maternity hospital during June 2006 to June 2009. The term "protracted postpartum urinary retention" was defined as the absence of adequate voiding beyond the third postpartum day. Study group comprised 55 women who developed protracted postpartum urinary retention. Control group comprised 110 women, matched by age and parity, who delivered at the same day but did not develop urinary retention.


RESULTS
Fifty-five (0.18%) women (41 primipara, 14 multipara) developed protracted postpartum urinary retention. On multivariate logistic regression analysis, only duration of the second stage of labor and vacuum deliveries was found to be significant independent risk factors. Thirty-six (65%) women achieved normal voiding within 4-14 days postpartum, and 19 (35%) others within 15-28 days. Higher postvoid residual urinary volume at 72 hr after delivery was associated with increased risk for late recovery. Forty-eight (87%) patients were available for 3-39 months follow-up. Of these, five (10.4%) had stress urinary incontinence, and four (8.3%) had overactive bladder symptoms. Three (6.3%) others had subjective voiding difficulties; however, urodynamic evaluation failed to reveal any voiding phase abnormalities.


CONCLUSIONS
Protracted postpartum urinary retention is uncommon in modern obstetric practice. The duration of the second stage of labor and vacuum deliveries were found to be significant independent risk factors. With early diagnosis and timely intervention, complete resolution is expected within 28 days postpartum with no extraordinary long-term consequences.
Groutz
Asnat
A
Urogynecology and Pelvic Floor Unit, Department of Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. agroutz@yahoo.com
Levin
Ishai
I
Gold
Ronen
R
Pauzner
David
D
Lessing
Joseph B
JB
Gordon
David
D
D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007557:Israel / Q000453:epidemiology; D016015:Logistic Models; D015999:Multivariate Analysis; D049590:Postpartum Period; D011247:Pregnancy; D015995:Prevalence; D012307:Risk Factors; D013997:Time Factors; D053201:Urinary Bladder, Overactive / Q000453:epidemiology* / Q000209:etiology; D014550:Urinary Incontinence, Stress / Q000453:epidemiology* / Q000209:etiology; D016055:Urinary Retention / Q000150:complications / Q000453:epidemiology*; D014554:Urination