Department of Obstetrics and Gynecology, Division of Urogynecology and Reconstructive Pelvic Surgery, Women and Infants Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA.
Department of Obstetrics, Gynecology and Reproductive Sciences, Yale New Haven Hospital, New Haven, CT, USA.
J Obstet Gynaecol. 2020 Nov;40(8):1118-1121. doi: 10.1080/01443615.2019.1706159. Epub 2020 Feb 18.
Postpartum urinary retention (PUR) is a common and potentially morbid condition if not recognised and managed promptly. We surveyed obstetrics and gynaecology (OBGYN) residents to determine residents' knowledge of the management of PUR. A total of 168 OBGYN residents in ACGME accredited programmes in the United States completed the survey. A percentage of 30.3 reported having a PUR prevention protocol at their institution, 43.3% reported not having a protocol and 26.7% did not know whether a protocol existed. About 89.3% of participants reported having previously taken care of a patient with PUR and 17.1% reported prior formal teaching on the management of PUR. Those who reported having a protocol were more likely to report feeling comfortable managing PUR. Overall, knowledge was low for management of PUR. Given the potential morbidity associated with inadequate management of PUR, formal education and standardisation through national guidelines may help improve care of patients with PUR.Impact statement PUR is a common condition and if left untreated may lead to long-term impacts on patients' health. Early recognition of the condition and appropriate management can prevent these complications. Protocols have been shown to improve patient outcomes. Thus, it has been postulated that the implementation of protocols could improve recognition of the condition. No previous studies have looked at the impact of PUR management protocols on physicians in training. Because physicians in training are often the first-in-line to manage patients at academic institutions, we sought to determine the proportion of obstetrics and gynaecology residents in the United States who report having a PUR management protocol at their institution and how this impacts their reported comfort at caring for patients with PUR, knowledge on PUR risk factors and recognition of scenarios concerning for PUR. While awareness of a PUR protocol did not lead to increased knowledge of risk factors or increased recognition of scenarios concerning for PUR, it did increase resident comfort with managing PUR patients. We also found that overall PUR knowledge was low. Based on our findings, OBGYN residents would benefit from having protocols at their institutions since it increased their comfort at managing patients with PUR. Further, formal education on PUR is likely needed to improve knowledge of risk factors and recognition of scenarios concerning for PUR.
产后尿潴留（PUR）如果不能及时发现和处理，是一种常见且潜在的病态情况。我们调查了妇产科住院医师，以确定他们对 PUR 管理的了解程度。美国经 ACGME 认证的项目中的 168 名妇产科住院医师完成了这项调查。有 30.3%的人报告说他们所在机构有 PUR 预防方案，43.3%的人报告说没有方案，26.7%的人不知道是否有方案。约 89.3%的参与者报告说曾护理过 PUR 患者，17.1%的人报告说曾接受过 PUR 管理的正规教学。那些报告说有方案的人更有可能对管理 PUR 感到舒适。总体而言，对于 PUR 的管理，知识水平较低。鉴于 PUR 管理不当可能带来的潜在发病率，通过国家指南进行正式教育和标准化可能有助于改善 PUR 患者的护理。
PUR 是一种常见疾病，如果不加以治疗，可能会对患者的健康造成长期影响。早期识别病情并进行适当的治疗可以预防这些并发症。方案已被证明可以改善患者的治疗效果。因此，有人提出实施方案可以提高对病情的识别。以前没有研究探讨 PUR 管理方案对住院医师的影响。因为住院医师通常是在学术机构中首先管理患者的医生，所以我们试图确定美国妇产科住院医师中有多少人报告说他们所在机构有 PUR 管理方案，以及这对他们报告的护理 PUR 患者的舒适度、对 PUR 风险因素的了解程度以及对 PUR 相关情况的识别能力有何影响。虽然对 PUR 方案的认识并没有增加对风险因素的了解或对 PUR 相关情况的识别，但确实增加了住院医师对管理 PUR 患者的舒适度。我们还发现，总体而言，PUR 知识水平较低。基于我们的发现，妇产科住院医师将从他们所在机构的方案中受益，因为这可以提高他们管理 PUR 患者的舒适度。此外，可能需要对 PUR 进行正式教育，以提高对风险因素的认识和对 PUR 相关情况的识别。
