In contrast to simple PUR, the prolonged form of PUR could be the result of a cumulative effect of different single risk factors.

The pathophysiology of postpartum urinary retention (PUR) is still unclear. The prevalence rate varies with the definition used and the literature discusses various risk factors. Bladder catheterization is the treatment of choice, but the best way to do it is not ascertained. Long-term sequelae seem to be rare. There are no widely accepted preventive measures. Our 2 cases illustrate that it is important to prevent PUR not only by avoiding the known risk factors, but also by additionally asking for signs of voiding dysfunction postpartum.

In the subgroup of women less than 50 years an (detectable) infection due to Mycoplasma or Ureaplasma leads typically to LUTS with normal filling cystometry, whereas no such findings were relevant for the elderly women.

Postpartum urinary retention (PUR) is a clinical condition that is neither well-recognized nor defined by standardized means but normally has a good prognosis. We present the case of a woman with a history of PUR who demonstrated recurrent PUR. Prolonged first and second stage of labor, isolated prolonged second stage of labor, forceps delivery or vacuum extraction, perineal laceration, nulliparity and epidural anesthesia can act as independent risk factors for the development of PUR. In this case, epidural anesthesia, which was administered in both deliveries, was the only risk factor, suggesting that its application in a woman with a history of PUR should be carefully considered and discussed with the patient. Bladder drainage resolves PUR, after which there seems to be no cumulative risk for voiding dysfunction. An initial smaller post-void residual bladder volume may have a predictive value concerning the time to resolution of PUR.