Department of Obstetrics and Gynaecology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India.
J Gynecol Obstet Hum Reprod. 2021 Feb;50(2):101837. doi: 10.1016/j.jogoh.2020.101837. Epub 2020 Jun 23.
Postpartum urinary retention (PUR) is not an uncommon consequence of bladder dysfunction after vaginal delivery. Despite its ubiquity, morbidity and discomfort brought to the postpartum women, it's a poorly discussed condition. Patients with Overt PUR are unable to void spontaneously within 6h of vaginal delivery and those with Covert PUR are able to void spontaneously but have a post void residual bladder volume (PVRV) of >150mL. Reported incidences of PUR vary widely ranging from 1.7 %-17.9 %.
To identify the prevalence and obstetric risk factors for PUR after vaginal delivery in order to identify women with increased risk of PUR.
The PVRV of women who delivered vaginally was measured after the first spontaneous micturition by ultrasonography. PVRV of more than 150mL was considered as covert PUR. Patient data including age, obstetric history, mode of delivery, duration of labor, PVRV were compared between women with and those without PUR.
Of 878 included women, the overall prevalence of PUR after vaginal delivery was 12.9 %, the prevalence of overt and covert PUR were 1.8 % and 11.04 % respectively. Parturient who were primigravidae, had perineal injury, instrumental delivery, birth weight >3.5kg and a longer duration of second stage of labor were risk factors for developing PUR.
Any misdiagnosis or delay in diagnosis of PUR can cause bladder over distension leading to irreversible detrusor damage. Hence vigilant monitoring and early detection of PUR helps in facilitating timely interventions and prevention of immediate and long term sequelae.
产后尿潴留（PUR）是阴道分娩后膀胱功能障碍的常见后果。尽管它普遍存在，给产后女性带来了发病率和不适，但它是一个讨论不足的病症。显性 PUR 患者在阴道分娩后 6 小时内无法自行排尿，而隐性 PUR 患者能够自行排尿，但膀胱残余尿量（PVRV）>150mL。报道的 PUR 发生率差异很大，范围从 1.7%到 17.9%。
确定阴道分娩后 PUR 的患病率和产科危险因素，以便识别有 PUR 风险增加的女性。
通过超声检查测量阴道分娩后首次自发排尿后女性的 PVRV。PVRV 超过 150mL 被认为是隐性 PUR。比较有和没有 PUR 的女性之间的患者数据，包括年龄、产科史、分娩方式、分娩时长、PVRV。
在 878 名纳入的女性中，阴道分娩后 PUR 的总体患病率为 12.9%，显性和隐性 PUR 的患病率分别为 1.8%和 11.04%。初产妇、会阴损伤、器械分娩、出生体重>3.5kg 和第二产程较长是发生 PUR 的危险因素。
任何对 PUR 的误诊或延迟诊断都可能导致膀胱过度扩张，导致不可逆转的逼尿肌损伤。因此，对 PUR 进行警惕监测和早期发现有助于及时干预，预防即刻和长期后遗症。
