Prevalence and risk factors for postpartum urinary retention after vaginal delivery in Japan: A case‐control study

Abstract

Aim This study aimed to clarify the prevalence and risk factors of postpartum urinary retention after vaginal delivery. It also described the healing process of women who had postpartum urinary retention. Methods In this case‐control study, 77 women who had postpartum urinary retention were matched by age and parity with 385 women as controls. Data were analyzed by conditional logistic regression analysis. Data were collected from the women in the case group regarding their healing process and conditions for urinary retention (overt or covert urinary retention). Results The prevalence of postpartum urinary retention was 1.2%. The adjusted odds ratio and the 95% confidence intervals for risk factors were as follows: epidural analgesia 4.72, 95% CI 2.38, 9.39; episiotomy 2.68, 95% CI 1.40, 5.13; length of second stage of labor 1.85, 95% CI 0.98, 3.49; labor augmentation 1.78, 95% CI 0.90, 3.51; instrument delivery 0.96, 95% CI 0.43, 2.17; and Kristeller maneuver 0.93, 95% CI 0.37, 2.37. Among 59 women with overt urinary retention, 29 (49.2%) transitioned to covert urinary retention within 10 days after delivery. More than half of the women were normal within 72 hr, but there were five women whose urinary retention did not resolve 11 days following delivery. Conclusions The statistically significant risk factors for postpartum urinary retention were epidural analgesia and episiotomy. Initiatives for the prevention and management of postpartum urinary retention are necessary.

Prevalence and risk factors of overt postpartum urinary retention among primiparous women after vaginal delivery: a case-control study

“…In the present study, episiotomy and second-degree perineal tears were both identified as independent risk factors for PUR, which is in line with the findings of previous studies [ 6 , 19 , 27 , 30 , 31 ]. In a systematic review by Mulder et al [ 12 ], episiotomy was found to be directly related to PUR.…”

“…In the past 20 years, the incidence of overt PUR has been reported to be as low as 0.14% [ 18 ], while Gema et al reported a higher incidence of 9.85% [ 14 ]. This large variation in morbidity may be due to the different definitions of overt PUR and inclusion criteria, such as including women who deliver via caesarean section [ 19 ]. Compared with primiparas, multiparas who have a shorter labour process, and lower rates of analgesic delivery, and proportions of instrument-assisted delivery may have a higher incidence of PUR [ 20 ].…”

“…In previous studies, univariate analyses confirmed that PUR is commonly associated with epidural analgesia, prolonged stages of labour, episiotomy, instrumental delivery, perineal tears, vulvar oedema, neonatal birth weight, and other factors [ 4 , 6 , 7 , 9 ]. However, the results are inconsistent regarding independent risk factors [ 6 , 13 , 14 , 18 , 19 ]. Our findings revealed that epidural analgesia, vulvar oedema, forceps delivery, episiotomy, and second-degree perineal tears were independent factors.…”

Risk factors and management of postpartum urinary retention: A scoping review

“…The final review includes one systematic review, 11 one multicentre randomized controlled clinical trial, 13 five retrospective casecontrol studies, [14][15][16][17][18] one retrospective medical review, 19 two retrospective analysis, 20,21 two prospective observational studies, 22,23 two case-control studies, 24,25 one prospective before-after study, 26 one cross-sectional study 27 and one clinical practice guideline. 28…”

The frequency of post-partum urinary retention (PPUR) and factors contributing PPUR after vaginal delivery.

“…Study conducted by Izumi Kawasoe in Japan and reported prevalence of postpartum urinary retention was 1.2%. 24…”