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Recurrent postpartum urinary retention: a case report
Joerg Humburg1, Ariane Ladewig, Irene Hoesli
1Department of Obstetrics and Gynecology, University Women's Hospital, Spitalstrasse, Switzerland. jhumburg@uhbs.ch
Postpartum urinary retention (PUR) is a clinical condition that is neither well-recognized nor defined by standardized means but normally has a good prognosis. We present the case of a woman with a history of PUR who demonstrated recurrent PUR. Prolonged first and second stage of labor, isolated prolonged second stage of labor, forceps delivery or vacuum extraction, perineal laceration, nulliparity and epidural anesthesia can act as independent risk factors for the development of PUR. In this case, epidural anesthesia, which was administered in both deliveries, was the only risk factor, suggesting that its application in a woman with a history of PUR should be carefully considered and discussed with the patient. Bladder drainage resolves PUR, after which there seems to be no cumulative risk for voiding dysfunction. An initial smaller post-void residual bladder volume may have a predictive value concerning the time to resolution of PUR.
Postpartum urinary retention (PUR) is a clinical condition that is neither well-recognized nor defined by standardized means but normally has a good prognosis. We present the case of a woman with a history of PUR who demonstrated recurrent PUR. Prolonged first and second stage of labor, isolated prolonged second stage of labor, forceps delivery or vacuum extraction, perineal laceration, nulliparity and epidural anesthesia can act as independent risk factors for the development of PUR. In this case, epidural anesthesia, which was administered in both deliveries, was the only risk factor, suggesting that its application in a woman with a history of PUR should be carefully considered and discussed with the patient. Bladder drainage resolves PUR, after which there seems to be no cumulative risk for voiding dysfunction. An initial smaller post-void residual bladder volume may have a predictive value concerning the time to resolution of PUR.
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