Retrospective Clinical Characterization of Women with Prolonged Persistent Postpartum Urinary Retention

Abstract

Abstract Purpose Prolonged postpartum urinary retention (PPUR) is a rare form of urinary retention lasting longer than 3 days after delivery, and no clinical standards exist for the diagnosis and treatment of this emotionally distressing and uncomfortable condition. The objectives of this study were to determine the prevalence of PPUR at a single institution and to define the clinical features of women who developed PPUR. Methods We retrospectively reviewed the clinical characteristics of 14 women who were diagnosed with non-iatrogenic PPUR at a single tertiary care center in Detroit, Michigan between October 2013 and December 2020. Demographics and clinical characteristics were analyzed with descriptive statistics. Results Of 60,352 deliveries, 14 (0.023%) women developed PPUR. Mean ± standard deviation age was 30.1 ± 6.1 years and body mass index was 27.3 ± 9.5 kg/m². A total of 12 (86%) patients received neuraxial anesthesia, 11 (79%) delivered vaginally, and the mean second stage of labor was 2.6 ± 1.9 hours. Median (range) onset of urinary retention was 12 (2–72) hours postpartum, and median duration of urinary retention until resolution was 6 (4–41) days. Median postvoid residual volume was 838 (313–1250) mL. Conclusion PPUR occurred at a low rate. Most women with PPUR had received neuraxial anesthesia, had vaginal deliveries, and experienced a prolonged second stage of labor. Large studies are needed to elucidate PPUR risk factors so that standard guidelines can be implemented for rapid diagnosis and treatment of this rare complication of pregnancy.