Covert postpartum urinary retention, is there a place for routine bladder ultrasound in postpartum care ?

Year 2021, Volume: 38 Issue: 2, 138 - 142, 03.04.2021

Kazibe Koyuncu , Batuhan Turgay , Bulut Varlı , Can Ozan Ulusoy , Ruşen Aytaç , Feride Söylemez

Abstract

Objective: Postpartum urinary retention(PUR) is defined as inability to void after six
hours from delivery or having abnormal post-void residual volume after delivery
(PVRV). Overt PUR is easily detectable condition but covert PUR usually remains
undiagnosed. We aim to investigate the incidence of covert PUR and identify the risk
factors.

Material and Methods: A retrospective analysis of the postpartum women was
undertaken between January-July 2016. PVRV of the patients either delivered
vaginally or cesarean section were assessed with ultrasound after first micturition.
All the ultrasound scans were made by experienced gynecologist. PVRV of more
than 150 mL was defined as covert PUR. Maternal age, parity, BMI, type of delivery,
episiotomy, first urination time, fetal head circumference, labor augmentation and
fetal birth weight were investigated as possible risk factors for covert PUR. The
characteristics of the patients with or without covert PUR were compared.

Results: Of the 450 women included, 67 (17.49%) were diagnosed as covert PUR.
Birth weight (p= 0.001), head circumference (p=0.043), vaginal delivery (p=0.001)
and need for episiotomy (p=0.003) were statistically different between patients with
PVRV under 150 mL and above 150 mL. Fetal head circumference appeared as the
only independent risk factor for covert PUR (95% CI for OR=1.11-1.127, p=0.04).

Conclusions: Although covert PUR is a common problem after delivery, risk factors
and treatment have not been established. Until risk factors are identified clearly with
larger studies, postpartum routine PVRV evaluation may be beneficial for preventing
long-term voiding dysfunction problems.

Keywords

voiding dysfunction, vaginal delivery, urinary retension

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