Tiberon A, Carbonnel M, Vidart A, Ben Halima M, Deffieux X, Ayoubi J-M
Department of Gynecology and Obstetrics, Foch Hospital, 92150 Suresnes, France.
Department of Gynecology and Obstetrics, Foch Hospital, 92150 Suresnes, France.
J Gynecol Obstet Hum Reprod. 2018 Nov;47(9):437-441. doi: 10.1016/j.jogoh.2018.08.002. Epub 2018 Aug 22.
Our objective was to identify the risk factors for persistent postpartum urinary retention (PUR).
This multicenter retrospective case-control study included 91 women with PUR exceeding 400ml during the first urinary catheterization performed after delivery, from 2010 through 2015. Two groups were defined: one included 25 women with PUR that persisted longer than 3 days, and the other, comprising 66 women with PUR that lasted three days or less. We compared the two groups to define the risk factors. We also studied the outcome of the women with persistent PUR.
The time until diagnosis/management and the urinary volume at the first catheterization after delivery were both significantly greater in the group with persistent PUR (11h vs 7.8h and 1020ml vs 715ml, P<0.05). Multivariate logistic regression indicated that cesarean delivery, perineal tear or episiotomy, and fluid administration in the delivery room were also associated with the persistence of PUR (P<0.05).
Time in the management of urinary retention can cause bladder overdistension that can substantially delay its resolution. More attentive monitoring of voiding, could reduce the duration of this complication and thereby improve patient comfort and minimize long-term complications.
This multicenter retrospective study show that the time in the management of urinary retention is a major factor of persistent urinary retention.
我们的目标是确定产后持续性尿潴留（PUR）的风险因素。
这项多中心回顾性病例对照研究纳入了2010年至2015年期间产后首次导尿时尿潴留超过400ml的91名女性。定义了两组：一组包括25名PUR持续超过3天的女性，另一组包括66名PUR持续3天或更短时间的女性。我们比较这两组以确定风险因素。我们还研究了持续性PUR女性的结局。
持续性PUR组从分娩到诊断/处理的时间以及首次导尿时的尿量均显著更多（11小时对7.8小时，1020ml对715ml，P<0.05）。多因素逻辑回归表明，剖宫产、会阴撕裂或会阴切开术以及产房补液也与PUR的持续存在相关（P<0.05）。
尿潴留处理时间过长可导致膀胱过度膨胀，从而显著延迟其恢复。对排尿进行更密切的监测可缩短该并发症的持续时间，从而提高患者舒适度并使长期并发症降至最低。
这项多中心回顾性研究表明，尿潴留的处理时间是持续性尿潴留的一个主要因素。
