Long-term micturition problems of asymptomatic postpartum urinary retention: a prospective case-control study.

Autor: Mulder FEM; Department of Obstetrics and Gynaecology, Academic Medical Centre, Meibergdreef 9-room H4.240, 1105 AZ, Amsterdam, The Netherlands. f.e.mulder@amc.nl., Hakvoort RA; Department of Obstetrics and Gynaecology, Martini Hospital, Groningen, The Netherlands., de Bruin JP; Department of Obstetrics and Gynaecology, Jeroen Bosch Ziekenhuis, 's Hertogenbosch, The Netherlands., Janszen EW; Department of Obstetrics and Gynaecology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands., van der Post JAM; Department of Obstetrics and Gynaecology, Academic Medical Centre, Meibergdreef 9-room H4.240, 1105 AZ, Amsterdam, The Netherlands., Roovers JWR; Department of Obstetrics and Gynaecology, Academic Medical Centre, Meibergdreef 9-room H4.240, 1105 AZ, Amsterdam, The Netherlands.
Jazyk: angličtina
Zdroj: International urogynecology journal [Int Urogynecol J] 2018 Apr; Vol. 29 (4), pp. 481-488. Date of Electronic Publication: 2017 Sep 04.
DOI: 10.1007/s00192-017-3457-6
Abstrakt: Introduction and Hypothesis: Covert (asymptomatic) postpartum urinary retention (PUR) is defined as post-void residual volume (PVRV) ≥150 mL. Although often supposed to be a common and harmless phenomenon, no data are available on the potential long-term micturition problems of increased PVRV after vaginal delivery.
Methods: After the first spontaneous void post-vaginal delivery, PVRV was measured using a portable scanning device. Micturition symptoms were compared using validated questionnaires between women with PVRV < 150 mL and those with PVRV ≥150 mL until 1 year after delivery. Women with PVRV ≥ 150 mL were followed until complete bladder emptying was achieved.
Results: Data of 105 patients with PVRV < 150 mL and 119 with PVRV ≥ 150 mL were available for analysis. 75% of all patients included had PVRV ≥ 250 mL. More primiparous patients had PVRV ≥ 150 mL (p < 0.02). 92% of women with PVRV ≥ 150 mL after delivery were able to adequately empty their bladder within 4 days. One year after delivery, no statistically significant differences were found.
Conclusions: Covert PUR according to the definition of PVRV ≥ 150 mL, is a common and transient phenomenon that does not result in more lower urinary tract symptoms 1 year after delivery. Although the current definition is not useful in identifying postpartum women with a pathological condition, we suggest that the definition of covert PUR should be change to: "PVRV≥500 mL after the first spontaneous void after (vaginal) delivery." This cut-off value is the value at which some women do need more time to normalise emptying of the bladder. The exact clinical implications of covert PUR need to be further studied in this subcategory of women.
Databáze: MEDLINE
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