title: Voiding dysfunction in women following cesarean delivery.
abstract: OBJECTIVE
  This study was conducted to investigate the prevalence of postpartum voiding difficulty (PVD) in women after cesarean delivery that required urethral catheterization, and to illustrate its relationship with various relevant obstetric factors.
  
  
  METHODS
  For this observational study, 489 pregnant women who had cesarean delivery at ≥ 36 gestational weeks were recruited in a tertiary hospital. Urethral catheterization was implemented in women who could not void spontaneously after cesarean delivery. Patient characteristics, obstetric parameters, and incidences of obstructive voiding symptoms at 3 months postpartum were compared between women who had PVD and no PVD.
  
  
  RESULTS
  Fifty-six cesarean deliveries (11.5%) resulted in PVD. Maternal age > 35 years, emergency cesarean delivery, operation time > 60 minutes, and postoperative analgesia were significantly different between women with and without PVD. Logistic regression demonstrated that emergency cesarean delivery (odds ratio = 5.031, p < 0.001), operation time > 60 minutes (odds ratio = 2.918, p = 0.002), and postoperative analgesia (odds ratio = 7.610, p = 0.007) were independent risk factors of PVD. Nonetheless, all women had resolution of PVD by the time of hospital dismissal. At 3-month postoperative follow-up, three women (5.4%) had symptoms of straining and/or incomplete emptying.
  
  
  CONCLUSIONS
  Our results showed that emergency cesarean delivery, prolonged operation time and postoperative analgesia are the main contributing factors of PVD after cesarean delivery. If urinary retention can be detected in time, transient PVD is not detrimental to urinary function and does not subsequently lead to voiding problems.
authors.affiliation: Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Ching-Chung
authors.initials: CC
authors.lastname: Liang
authors.affiliation: Division of Urogynecology and Pelvic Floor Reconstruction, Department of Obstetrics and Gynecology, Chi Mei Foundation Hospital, Tainan, Taiwan; Department of Obstetrics and Gynecology, College of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Ming-Ping
authors.initials: MP
authors.lastname: Wu
authors.affiliation: Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Yao-Lung
authors.initials: YL
authors.lastname: Chang
authors.affiliation: Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Ho-Yen
authors.initials: HY
authors.lastname: Chueh
authors.affiliation: Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: An-Shine
authors.initials: AS
authors.lastname: Chao
authors.affiliation: Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan. Electronic address: gene@cgmh.org.tw.
authors.forename: Shuenn-Dhy
authors.initials: SD
authors.lastname: Chang
mesh_terms: D000328:Adult; D016058:Analgesia, Patient-Controlled / Q000706:statistics & numerical data; D000767:Anesthesia, Epidural / Q000706:statistics & numerical data; D002585:Cesarean Section / Q000009:adverse effects*; D004630:Emergencies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008423:Maternal Age; D061646:Operative Time; D010149:Postoperative Pain / Q000188:drug therapy; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D014546:Urinary Catheterization; D016055:Urinary Retention / Q000209:etiology*
keywords: cesarean delivery; postoperative analgesia; urinary retention; voiding difficulty