Voiding dysfunction in women following cesarean delivery

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.

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.

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.

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.