Giant Atonic Bladder (4000 mL) in the Postpartum Period: A Case Report

Postpartum urinary retention (PUR) is a well-recognized complication of childbirth. The prolonged duration and exceptionally large residual bladder volume of 4000 mL observed in this case, despite the patient's report of spontaneous voiding on the first postpartum day, is rare.

A 21-year-old primiparous woman presented on Postpartum Day 16 with abdominal distension. She reported no urinary symptoms. Her condition had previously been misattributed to postpartum infection during an earlier admission. She was diagnosed with covert PUR, and catheterization drained 4000 mL of urine. However, after 4 days of catheterization, the patient remained unable to void spontaneously. She was then managed with clean intermittent catheterization (CIC) for 2 weeks, and urinary tract function gradually recovered.

This case report stands out due to the extraordinary bladder volume and protracted course, providing a unique perspective on the spectrum of PUR severity. While routine postpartum discharge protocols rely on spontaneous voiding, this case emphasizes the importance of thorough subjective assessment of lower urinary tract symptoms (LUTSs) for early recognition of PUR to prevent such extreme presentations.