Voiding function in pregnancy and puerperium

H P Dietz1, C J Benness

  • 1Royal Prince Alfred Hospital, Sydney, Australia. hpdietz@bigpond.com

Bladder function changes significantly in pregnancy. This study prospectively examined voiding function in a nulliparous cohort. A total of 200 nulliparous women were seen twice during pregnancy and 2-5 months postpartum. Flowmetry, ultrasound estimation of residual urine and translabial ultrasound of bladder neck mobility were evaluated. The Liverpool nomograms were used to calculate maximum and average flow rate (MFR and AFR) centiles. Flowmetry was available on 186 women at 6-18 weeks, 165 women at 32-39 weeks and 162 women 2-5 months postpartum. Voided volumes decreased from 253 to 180 ml during pregnancy (p<0.001), increasing again to 198 ml postpartum. MFR centiles increased during pregnancy [from 49 (SD 28) to 58 (SD 29), p=0.003], and this trend continued postpartum [to 61.8 (SD 26.8), p<0.001]. Changes correlated weakly but significantly with changes in several parameters of bladder neck mobility (e.g. urethral rotation and MFR centiles, r=0.182, p=0.027). MFR and AFR centiles increase in pregnancy and with childbirth, and increases correlate weakly with changes in bladder neck mobility.

Related Concept Videos

Urodynamic Studies: Uroflowmetry01:19

Urodynamic Studies: Uroflowmetry

Uroflowmetry is a non-invasive urodynamic test designed to measure various aspects of urination, including volume, flow rate, and the time to void. This test is crucial for diagnosing and assessing conditions such as bladder outlet obstruction, bladder dysfunction, incomplete bladder emptying, incontinence, and urinary tract blockages caused by benign prostatic hyperplasia (BPH) and urethral strictures.Pre-Test Instructions:Before a uroflowmetry test, patients are typically advised to drink...
The Micturition Reflex01:26

The Micturition Reflex

Urination, or micturition involves the coordination of the bladder's detrusor muscle and two sphincters to ensure controlled bladder emptying.
The process begins with bladder filling, where the bladder wall stretches as urine accumulates. This stretching activates the urine storage reflex, mediated by the sacral spinal segments and the pontine storage center. Efferent sympathetic impulses stimulate the detrusor muscle to relax and the internal urethral sphincter to contract, facilitating urine...
Anatomy of the Genitourinary System II: Bladder and Urethra01:19

Anatomy of the Genitourinary System II: Bladder and Urethra

The lower urinary system consists of the urinary bladder and urethra, which are essential in storing and expelling urine from the body. Together with the internal and external sphincters, these structures work together to regulate urination effectively.Anatomy of the BladderThe urinary bladder is a muscular, stretchable organ behind the pubic bone and in front of the rectum. In females, the bladder is positioned anterior to the vagina and inferior to the uterus, while in males, it is located...
Imaging Studies VI: Voiding Cystourethrography and Cystography01:22

Imaging Studies VI: Voiding Cystourethrography and Cystography

Voiding Cystourethrography (VCUG) and Cystography are specialized radiographic procedures used to examine the structure and function of the bladder and urethra.Voiding Cystourethrography (VCUG)A Voiding Cystourethrogram (VCUG) is a diagnostic imaging procedure that assesses the anatomy and function of the lower urinary tract. It focuses on the bladder, bladder neck, and urethra, helping detect abnormalities such as vesicoureteral reflux (VUR)—the backward or reverse flow of urine into the...
Physiology of the Gastrointestinal System III: Elimination01:26

Physiology of the Gastrointestinal System III: Elimination

The gastrointestinal elimination process involves a complex interplay of neural and hormonal mechanisms that coordinate the final waste removal from the body. This intricate operation encompasses the absorption of water and electrolytes, vital for transforming the remaining indigestible food matter into feces. The large intestine is pivotal in water and electrolyte absorption, forming feces from unabsorbed minerals, undigested food, bacteria, bile pigments, and shed epithelial cells. Essential...
Physiology of Urine Formation01:24

Physiology of Urine Formation

Urine formation is an essential function of the human body. It plays a critical role in maintaining homeostasis by regulating the volume and composition of body fluids. The kidneys, the primary organs involved in this process, filter blood to remove waste products and excess substances, ultimately producing urine.
Glomerular Filtration
The first stage in urine formation is glomerular filtration. Each kidney contains approximately 1 million nephrons, the functional units of filtration, with a...