[Postartum urinary retention - without clinical impact?]

Postpartum urinary retention (PUR) continues to be a not very well understood clinical condition. The incidence varies in literature between 0.05 to 14.1%, after vaginal delivery, and between 3.3 to 24.1% after cesarean section, depending on the criteria used and reflecting differences in obstetrical practice. A commonly used definition is the lack of spontaneous micturition 6 hours after vaginal delivery or after removing an indwelling catheter. After helping measures, bladder drainage, which can be done in different ways is most important in the treatment. Though it is a distressing condition, prognosis is normally good, and there are only few published data on long-term sequelae. But overstretching the bladder wall during pregnancy or delivery can result in severe detrusor damage, followed by voiding dysfunction. There are different independent risk factors such as prolonged first and second stage of labor, isolated length of the second stage, forceps delivery or vaccum extraction, perineal laceration and nulliparity. Epidural analgesia may also increase the risk of PUR, but is controversially discussed in literature. The lack of guidelines is one of the major problems in treating women with PUR.