Incidence of abnormal voiding parameters in the immediate postpartum period

One hundred eighty-four patients were assessed prospectively by uroflowmetry and postmicturition ultrasonography on a daily basis in the immediate postpartum period to assess the incidence of abnormal voiding parameters, their predisposing factors, and whether the combination of two screening tests was more helpful than either alone as a screening test of abnormal voiding in the puerperium. The incidence of abnormal voiding parameters was 43%. The majority of these were asymptomatic. Of those patients who had an abnormality, 68% had normal voiding parameters by the time they went home, and all of those who returned for follow-up had normal parameters. Operative delivery, perineal trauma, and epidural anaesthesia all increased the incidence of abnormal voiding parameters. Residual urine was a feature in 70 of the 79 patients found to be abnormal, and the incidence of an abnormal flow rate was not significantly greater than in the nonpregnant population. This suggests that the addition of uroflowmetry does not confer any benefit over postmicturition assessment of residual urine by ultrasonography in the detection of patients with postpartum voiding dysfunction.