Objective:To assess the obstetrics risk factors for postpartum urinary retention after vaginal delivery. Material and Methods: Of 234 women with a vaginal delivery, 19 (8.1%) women who had postpartum urinary retention were cases, and 215 (91.9%) women who did not were controls. Postpartum urinary retention was defined as the presence of postvoid residual bladder volume ≥150 mL or the inability to void within 6 hours after vaginal delivery. Logistic regression analysis identified risk factors for urinary retention.Results: Prolonged duration of the second stage of labor (OR=0.46, 95% CI for OR=0.06-3.67, p<0.001), presence of episiotomy (OR=0.07, 95% CI for OR=0.01-0.68, p=0.022) and perineal laceration (OR=97.09, 95% CI for OR=7.93-1188.93, p<0.001), and birth weight of >4000 g for the newborn (OR=0.04, 95% CI for OR=0.01-0.20, p<0.001) were found as independent risk factors for postpartum urinary retention after vaginal delivery.
Conclusion:Postpartum urinary retention after vaginal delivery is a relatively common condition. Awareness of risk factors, including prolonged second stage of labor, episiotomy, perineal lacerations, and macrosomic birth, may allow us to take the necessary precautions against this complication. (J Turk Ger Gynecol Assoc 2014; 15: 140-3)
The pain that study participants felt during and soon after OH was negatively affected by preprocedural anxiety levels. Some factors, such as reducing the waiting time before the procedure, might be useful in reducing anxiety levels.
The aim of this study was to assess the effects of home-based Kegel exercises in women with stress and mixed urinary incontinence. A total of 90 women with urodynamically proven urinary stress (SUI) and mixed (MUI) incontinence awaiting anti-incontinence surgery were recruited in the urogynaecology clinic of Ankara Zekai Tahir Burak Women's Health Research and Education Hospital. Of these, 18 women were excluded due to low compliance and the remaining 72 were divided into two groups according to urodynamic diagnosis (SUI group, n = 38; MUI group, n = 34). Age, BMI, menopausal status and medical history of the women were recorded. The women took Kegel exercise, consisting of 10 sets of contractions/day; each set included 10 repetitions, for at least 8 weeks. To evaluate the pelvic floor muscle strength, the modified Oxford grading system was used before and after Kegel exercising. The Incontinence Impact Questionnaire (IIQ-7); Urogenital Distress Inventory (UDI-6) and the Patient Global Impression of Improvement (PGI-I) questions were compared before and after 8 weeks of Kegel exercising. The age, BMI, gravidity, menopausal status, macrosomic fetus history, hypertension and asthma were similar between the groups. There were statistically significant lower scores in both IIQ-7 and UDI-6 before and after Kegel exercises within each group (p < 0.001). The mean change of the IIQ-7 and UDI-6 score was statistically significantly higher in the SUI group than in the MUI group (p = 0.023 and p = 0.003, respectively). Results of the Oxford scale were also statistically significantly higher after Kegel exercises within each group (p = < 0.001). In total, 68.4% of the women in the SUI group and 41.2% of the women in the MUI group reported improvements which were statistically significant (p = 0.02). We conclude that home-based Kegel exercises, with no supervision, have been found effective in women with SUI and MUI. The improvement was more prominent in women with SUI.
The continuous suturing techniques for episiotomy closure, compared to interrupted methods, are associated with less short-term pain, are quicker and also need less suture material.
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