Postpartum voiding in the primiparous after vaginal delivery
Abstract
To study the voiding pattern after a ‘normal’ vaginal delivery, uroflowmetry and residual urine (RU) measurements (ultrasonography) were performed at the first postpartum voiding and on the 3rd and 5th postpartum days in 51 primiparous women. The bladder volume and the RU were significantly increased, while the corrected (for volume differences) peak flow rate was significantly decreased in the immediate postpartum period. The RU was positively correlated to the total bladder volume (r=28, p=0.05), birthweight (r=0.29, p=0.04) and head circumference (r=0.37, p=0.01), indicating that overdistension of the bladder, possibly due to transiently impaired nervous function, caused by mechanical stress, may play a role. No parturients developed acute urinary retention, and the voiding pattern normalized within a few days. No urinary infections were diagnosed. No correlation could be established between the time from delivery to the first voiding and the voided volume or the total bladder volume, respectively. It is concluded that the emptying function is slightly impaired, which, however, seems to be of limited clinical significance, and that the time after delivery per se is a poor predictor of the bladder volume.
Keywords
Postpartum voiding Vaginal deliveryPreview
Unable to display preview. Download preview PDF.
References
- 1.Malpas P, Jeffcoate TNA, Lister UM. The displacement of the bladder and urethra during labour. J Obstet Gynaecol Br Emp 1949; 56:949–960Google Scholar
- 2.Grove LH. Backache, headache and bladder dysfunction after delivery. Br J Anaesth 1973; 45:1147–1149Google Scholar
- 3.Francis WJA. Disturbances of bladder function in relation to pregnancy. J Obstet Gynaecol Br Emp 1960; 57:353–366Google Scholar
- 4.Weil A, Reyes H, Rottenberg RD, Beguin F, Herrmann WL. Effect of lumbar epidural analgesia on lower urinary tract function in the immediate postpartum period. Br J Obstet Gynaecol 1983; 90:428–432Google Scholar
- 5.Tapp AJS, Meire H, Cardozo LD. The effect of epidural analgesia on postpartum voiding. Neurourol Urodyn 1987; 6:235–237Google Scholar
- 6.Fedorkow DM, Drutz HP, Mainprize TC. Characteristics of patients with postpartum urinary retention. Int Urogynecol J 1990; 1:136–184Google Scholar
- 7.Lapides S. Mechanisms of urinary tract infection. Urology 1979; 14:217–225Google Scholar
- 8.Versi E, Barnick C. Postpartum urinary retention. Proc ICS 17th. Ann Meeting, Bristol 1987: 218–219Google Scholar
- 9.Hinman F. Postoperative overdistension of the bladder. Surg Gynecol Obstet 1976; 142:901–902Google Scholar
- 10.Pedersen JF. Determination of residual urine by ultrasonic scanning. Ugeskr Laeger 1979; 141:649–650Google Scholar
- 11.Backman KA. Urinary flow during micturition in normal woman. Acta Chir Scand 1965; 130:357–370Google Scholar
- 12.Haylen BT, Ashby D, Sutherst JR, Frazer MI, West CR. Maximum and average urinary flow rates in normal male and female populations — the Liverpool normograms. Br J Urol 1989; 64:330–338Google Scholar
- 13.Siegel S. Nonparametric statistics for the behavioral sciences. New York, McGraw Hill, 1988Google Scholar
- 14.Kerr-Wilson RHJ, Thompson SW, Orr JW, Davis RO, Cloud GA. Effect of labor on the postpartum bladder. Obstet Gynecol 1984; 64:115–117Google Scholar
- 15.Youssef AF. Cystometric studies in gynecology and obstetrics. Obstet Gynecol 1956; 8:181–188Google Scholar
- 16.Bennetts FA, Judd GE. Studies of the postpartum bladder. Am J Obstet Gynecol 1941; 142:419–427Google Scholar
- 17.Burkhart FL, Porges RF, Gibbs CE. Bladder capacity postpartum and catheterization. Obstet Gynecol 1965; 2:176–179Google Scholar
- 18.Barnick CG, Benness C, Cardozo L. Postpartum voiding dysfunction. Proc ICS 19th. Ann Meet, Ljubljana 1989:64–65Google Scholar
- 19.Kermans G, Wyndaele JJ, Thiery M, De Sy W. Puerperal urinary retention. Acta Urol Belg 1986; 54:376–385Google Scholar
- 20.Miodrag A, Castleden CM, Ekelund P, Burton R. Direct and indirect effects of estrogen on the rat detrusor muscle. Proc ICS 19th. Ann Meet, Ljubljana 1989: 44–45Google Scholar