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Postpartum voiding dysfunction: Identifying the risk factors
Author(s) -
Buchanan Julie,
Beckmann Michael
Publication year - 2014
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/ajo.12130
Subject(s) - medicine , urinary retention , birth trauma , uterine atony , pregnancy , obstetrics , caesarean section , pelvic floor dysfunction , confounding , incidence (geometry) , childbirth , gynecology , surgery , hysterectomy , urinary incontinence , genetics , physics , optics , biology
Background Postpartum urinary retention ( PPUR ) (also known as voiding dysfunction) is a common problem, defined as the inability to completely void after giving birth. If voiding dysfunction is not recognised, bladder overdistension can lead to denervation, detrusor atony and prolonged voiding dysfunction. Aim To describe the incidence of PPUR amongst postpartum women undergoing routine bladder scanning and to identify the factors that lead to postpartum voiding dysfunction. Methods A retrospective analysis of all postpartum women at Mater Health Services, Brisbane between February and December 2012 was undertaken. Routinely collected postvoid residual bladder volumes ( PVRBV ) were reported using a bladder scanner at four and six hours and two to three days postbirth or following removal of an indwelling catheter ( IDC ). The characteristics of women with or without increased PVRBV were analysed. Results Postvoid residual bladder volumes at four‐hours postbirth/removal of IDC were available for 5558 women of whom 281 (5.1%) had a residual volume measured >150 mL. Obstetric factors explored included mode of birth, method of analgesia or anaesthesia, duration of labour, degree of perineal trauma, birth weight, gestation, parity, maternal age and body mass index. After controlling for confounders, nulliparity (aOR 1.53; 95% CI 1.05–2.26), birth by caesarean section (aOR 2.21; 95% CI 1.10–4.41) and 3rd/4th degree perineal trauma (aOR 2.01; 95% CI 1.09–3.72) were significant independent predictors of PPUR. Conclusion Following the introduction of a protocol of timed voiding and routine measurement of PVRBV after birth/removal of IDC , PPUR is uncommon. Adopting a risk‐factor‐based approach to PVRBV screening is not supported by these data.