Protracted Postpartum Urinary Retention: Incidence, Risk Factors, and Natural History of a Rare Postpartum Urinary...

Postpartum urinary retention (PUR) is a multifactorial condition that requires a high degree of clinical suspicion for timely diagnosis and proper intervention.

The aims of the study are to describe PUR incidence and to compare natural history, obstetric characteristics, and associated risk factors for protracted PUR (extending ≥3 days postpartum) versus PUR.

This is a retrospective cross-sectional study of women who underwent an obstetric delivery over 24 months at an academic institution. International Classification of Diseases, Tenth Revision, codes were used to identify PUR. Patient characteristics, obstetric delivery data, and peripartum care surrounding delivery were collected. A P value of 0.05 or less was significant.

Between January 1, 2018, and December 31, 2019, there were 23,844 deliveries (vaginal and cesarean section) and 77 patients (0.32%) experienced PUR. Within this group, 12 (0.05%) experienced protracted PUR. Patients with protracted PUR had a significantly later postpartum diagnosis day (median 1 [interquartile range, 1-2] vs 1 [0-1], P = 0.004), longer time to retention onset (22.0 [10.7-37.0] vs 10.7 [7.9-19.4] hours, P = 0.03), and greater retention duration (12.5 [5.5-17.0] vs 1.0 [0.0-1.0] days, P < 0.001) compared with those with PUR. There were no significant differences in patient or delivery characteristics for those delivering vaginally between the groups.

Protracted PUR is rare, occurring in 0.05% of deliveries. Women with protracted PUR were more likely to have a greater onset time, later diagnosis date, and longer retention duration, out to 47 days, compared with women with PUR resolution before postpartum day 3.