Prospective Clinical Study for Asymptomatic Urinary Retention in Post-partum Period

Choi, Jin Sun; Kim, Dae Kyung; Hwang, In Taek

Abstract

PURPOSE: Asymptomatic urinary retention in the post-partum period is a relatively common problem. We investigated prospectively the incidence and the various risk factors associated with asymptomatic urinary retention in post-partum.
MATERIALS AND METHODS
From Feb. 1999 to Apr. 1999, all pregnant women who visited our hospital for delivery were evaluated. Among them 103 women who had undergone vaginal delivery were evaluated, Exclusion criteria were cesarean section, incidental catheter indwelling during delivery, and symptomatic urinary retention. Residual urine volume was measured using BladderScanTM BVI 2500(Diagnostic Ultrasound co.) within 10 minutes after first voiding in immediate post-partum period. Asymptomatic urinary retention was defined as residual urine volume over 150ml. Pre-partal urinary symptoms and various obstetric parameters were evaluated in asymptomatic urinary retention group and normal group as control. Asymptomatic urinary retention group were followed up daily to monitor their post-void residual urine volume.
RESULTS
The incidence of asymptomatic urinary retention after vaginal delivery was 13.6%. Factors associated with asymptomatic urinary retention included second stage of labor, episiotomy, and instrumental delivery. There was no relationship between pre-partal lower urinary tract symptoms and post-partal asymptomatic urinary retention. In patients with asymptomatic urinary retention, catheterization was done for removing residual urine and thus preventing progression of further distension. Post-void residual volume was normalized within 3 days in all patients.
CONCLUSIONS
Asymptomatic post-partum urinary retention is a self-limiting phenomenon associated with various traumatic events during hard labor such as prolonged labor, episiotomy, instrumental delivery. Close observation of voiding patterns in patients with risk factors is needed to prevent myogenic failure associated with unrecognized asymptomatic post-partum urinary retention.