Risk factors and management of persistent postpartum urinary retention

Tiberon, A.; Carbonnel, Marie; Vidart, A.; Halima, M. Ben; Deffieux, X.; Ayoubi, Jean Marc

doi:10.1016/j.jogoh.2018.08.002

Cited by 17 publications

(37 citation statements)

References 19 publications

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“…According to recent reports, PUR is classified as overt, covert, and persistent PUR [ 1 , 3 , 16 , 17 ]. Overt PUR is symptomatic, requires treatment, and may result in persistent PUR in case of inadequate management, while covert PUR is asymptomatic and mostly self-healing.…”

Section: Discussionmentioning

confidence: 99%

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

Cao

Rao

Yuan

et al. 2022

BMC Pregnancy Childbirth

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Background Postpartum urinary retention (PUR) may lead to bladder neuromuscular damage and subsequently voiding dysfunction. However, the literature regarding the incidence of and risk factors for PUR remains unclear. Moreover, previously reported studies are limited to small sample sizes. Thus, this study aimed to assess the incidence of and risk factors for overt PUR after vaginal delivery. Methods This retrospective case-control study included all primiparas who delivered vaginally between July 1, 2017, and June 30, 2019, at our institution. The case group comprised 677 women diagnosed with overt PUR who required catheterisation after delivery. The control group comprised 677 women without overt PUR randomly selected in a 1:1 ratio matched for date of delivery and who delivered immediately after each woman with overt PUR to minimise the impact of variations over time in obstetric practice. Univariate and multivariate logistic regression analyses were performed to investigate the factors associated with overt PUR. Results Of the 12,609 women included in our study, 677 were diagnosed with overt PUR (incidence 5.37%). Univariate analysis identified epidural analgesia, episiotomy, perineal tears, instrument-assisted delivery, duration of labour stage, intrauterine operation, and vulvar oedema as risk factors for PUR. Multivariate logistic regression identified epidural analgesia (odds ratio [OR] = 1.41, 95% confidence interval [CI]: 1.11–1.79, P = 0.005), vulvar oedema (OR = 6.92, 95% CI: 4.65–10.31, P < 0.001), forceps delivery (OR = 8.42, 95% CI: 2.22–31.91, P = 0.002), episiotomy (OR = 1.37, 95% CI: 1.02–1.84, P = 0.035), and second-degree perineal tear (OR = 3.42, 95% CI: 2.37–4.94, P < 0.001) as significant independent risk factors for PUR. Conclusions PUR was highly associated with epidural analgesia, forceps delivery, vulvar oedema, episiotomy, and second-degree perineal tears. More attention should be paid to women at high risk to reduce the incidence of PUR.

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Section: Discussionmentioning

confidence: 99%

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

Cao

Rao

Yuan

et al. 2022

BMC Pregnancy Childbirth

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“…In more recent studies, independent risk factors for covert PUR were episiotomy, epidural analgesia, and birth weight (Mulder, Oude Rengerink, van der Post, Hakvoort, & Roovers, 2016). According to Tiberon et al (2018), risk factors for persistent PUR lasting more than 72 hr were cesarean delivery, perineal tear or episiotomy, and fluid administration in the delivery room. In Japan, although there have been case studies of PUR, there has not yet been any research on risk factors.…”

Section: Introductionmentioning

confidence: 99%

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

Kawasoe

Kataoka

2019

Japan Journal Nursing Sci

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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.

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“…13 The factors that affect postpartum urinary retention and found that every 10 minutes increase in second stage labour causes 6% increase in postpartum urinary retention risk, and every 1-minute increase in the interval between postpartum period and fi rst spontaneous voiding could increase the risk of postpartum urinary retention by 4%. [14][15][16] We also found that postpartum urinary retention incidence was more prevalent in patients who underwent episiotomy, which are 30 patients (86%). Bivariate and multivariate analysis showed that there was an association between postpartum urinary retention and episiotomy with a p-value of 0.01.…”

Section: Discussionmentioning

confidence: 71%

Association of Obstetric Risk Factors with Postpartum Urine Retention in Spontaneous Labor

Budinurdjaja

Nizomy

Sabaruddin

2021

Indones J Obstet Gynecol

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Objective: To determine the relationship between obstetric risk factors and the incidence of postpartum urinary retention in spontaneous labour at RSUD Ulin Banjarmasin.Methods: This clinical study used an analytical observational design with a cross-sectional approach. The population of this study was patients with a diagnosis of postpartum urinary retention in spontaneous labour in the delivery ward and postpartum ward of Ulin Banjarmasin Hospital between January 2018-January 2020. The sample for this study was a part of the target population selected by purposive sampling, which fulfilled the inclusion and exclusion criteria. Data were analyzed using the Chi square test and multivariate analysis using binary logistics.Results: The results showed 35 samples of patients diagnosed with postpartum urinary retention in spontaneous labour and had met the inclusion and exclusion criteria. Characteristic data of the study samples found that most of the study subjects were more than 35 years old, 27 patients (77%), 21 patients (60%) of cases with primigravida parity, 26 patients (76%) with the duration of second stage labour more than equal to 1 hour. Episiotomy was performed in 30 patients (86%), 34 patients (97%) had a newborn birthweight of less than 4000 grams. There was a significant association between the risk factors for parity in primigravida (p-value 0.02), second stage labour duration in primigravida (p-value 0.01), and episiotomy (p-value 0.01), with postpartum urinary retention in spontaneous labour. In contrast, age (p-value 0.19), and birthweight (p-value 0.10) were not significantly associated with postpartum urinary retention in spontaneous labour.Conclusions: There were significant associations between obstetric risk factors (parity, duration of second stage labour, and episiotomy) with postpartum urinary retention in spontaneous labour. Whereas age and birth weight were not significantly associated with postpartum urinary retention in spontaneous labour.Keywords: obstetric risk, postpartum retention, spontaneous delivery. Abstrak Tujuan: Mengetahui hubungan faktor risiko obstetrik dengan kejadian retensio urin postpartum pada persalinan spontan di RSUD Ulin Banjarmasin.Metode: Penelitian ini merupakan penelitian klinis dengan rancangan observasional analitik dengan pendekatan potong lintang. Populasi dari penelitian ini adalah ibu postpartum yang didiagnosis dengan retensio urin postpartum pada persalinan spontan di kamar bersalin dan di ruangan nifas RSUD Ulin Banjarmasin periode Januari 2018-Agustus 2020. Data dianalisis bivariat menggunakan uji Chi square dan analisis multivariate dengan menggunakan binary logistik.Hasil: Didapati 35 sampel yang didiagnosis retensio urin postpartum pada persalinan spontan dan memenuhi kriteria inkulusi dan eksklusi. Data karakteristik sampel penelitian ditemukan usia terbanyak subyek penelitian berusia lebih dari 35 tahun sebanyak 27 pasien (77,14%), kasus dengan paritas primigravida sebanyak 21 pasien (60%), lama kala dua primigravida lebih dari sama dengan 1 jam sebanyak 26 pasien (76%). Tindakan episiotomi sebanyak 30 pasien (86%), berat bayi lahir terbanyak pada berat kurang dari 4.000 gram yaitu sebnyak 34 pasien (97%). Terdapat hubungan yang bermakna pada faktor risiko paritas pada primigravida dengan p value 0,02, lama kala dua dengan p value 0,01, dan tindakan episotomi dengan p value 0.01 dengan kejadian retensio urin postpartum sedangkan didapatkan hasil yang tidak bermakna pada risiko obstetrik usia dengan p value 0.19 dan berat bayi lahir dengan p value 0.10 pada kejadian retensio urin postpartum.Kesimpulan: Terdapat hubungan signifikan antara faktor risiko obstetrik (paritas, lama kala dua dan tindakan episotomi) dengan retensio urin postpartum persalinan spontan. Sedangkan umur dan berat badan lahir tidak berhubungan dengan retensio urin postpartum pada persalinan spontanKata kunci: persalinan spontan, risiko obstetrik, retensio postpartum.

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Risk factors and management of persistent postpartum urinary retention

Cited by 17 publications

References 19 publications

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

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

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

Association of Obstetric Risk Factors with Postpartum Urine Retention in Spontaneous Labor

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