You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Non-Neurogenic Voiding Dysfunction1 Apr 20121954 PREVALENCE, OBSTETRIC RISK FACTORS AND NATURAL HISTORY OF ASYMPTOMATIC POSTPARTUM URINARY RETENTION AFTER FIRST VAGINAL DELIVERY- A PROSPECTIVE STUDY OF 200 PRIMIPARA WOMEN Yael Salemnic, Ronen Gold, Joseph Har Toov, Ariel Jaffa, David Gordon, Joseph Lessing, and Asnat Groutz Yael SalemnicYael Salemnic Tel Aviv, Israel More articles by this author , Ronen GoldRonen Gold Tel Aviv, Israel More articles by this author , Joseph Har ToovJoseph Har Toov Tel Aviv, Israel More articles by this author , Ariel JaffaAriel Jaffa Tel Aviv, Israel More articles by this author , David GordonDavid Gordon Tel Aviv, Israel More articles by this author , Joseph LessingJoseph Lessing Tel Aviv, Israel More articles by this author , and Asnat GroutzAsnat Groutz Tel Aviv, Israel More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2113AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Pregnancy and childbirth have long been considered as risk factors in the genesis of pelvic floor disorders. Data regarding the correlation between obstetric parameters and childbirth-associated voiding phase disorders are scarce and controversial. The present study was conducted to assess the prevalence, obstetric risk factors and natural history of asymptomatic postpartum urinary retention (APUR) in modern obstetric practice. METHODS 200 consecutive primipara women who underwent vaginal delivery in a single university-affiliated maternity hospital were prospectively enrolled. Trans-abdominal ultrasound measurements of post-voiding residual urine volume (PVR) were undertaken at 24, 48 and 72 hours after delivery. PVR was calculated by using a validated formula for approximation of ellipsoid. APUR was defined as PVR >200ml and the lack of subjective voiding difficulties. Maternal and obstetric parameters were analyzed and compared between women with versus without APUR. Statistical analysis was performed using Student's t-test for continuous data and ÷2 or Fisher Exact test for categorical data. Sas® 9.2 for windows was used for the multivariate analysis. RESULTS 18 (9 %) women were found to have APUR. Mean PVR at diagnosis was 325±181 ml. Univariate comparison of cases with versus without APUR is presented in Table 1. Pre-pregnancy maternal weight, length of the 2nd stage of labor, prolonged 2nd stage (>120 minutes), and mediolateral episiotomy were found to be significantly more common among women with APUR. However, on multivariate model, only prolonged 2nd stage of labor (OR 3.920, 95% CI 1.180; 13.026) and mediolateral episiotomy (OR 5.772, 95% CI 1.509; 22.082) were found to be significant independent risk factors. All women with APUR achieved normal PVR within 72 hours postpartum. Table 1. Univariate comparison of cases with versus without APUR PVR < 200 ml (N=182) PVR > 200 ml (N=18) P value Age [year] 30.3±4.13 30.1±5.03 0.854 Pre-pregnancy BMI 22.43±4.2 24.54±4.12 0.049⁎ Gestational age [w] 40.2±1.2 40.0±1.2 0.493 Induction of labor 58(31%) 4(22%) 0.398 Use of oxytocin 126(69%) 16(88%) 0.079 Intrapartum fever 20(11%) 2(11%) 0.987 Epidural analgesia 166(91%) 17(94%) 0.638 2nd stage [min] 100.8±63.6 137.9±56.6 0.018⁎ 2nd stage >120 min 68(37%) 13(72%) 0.004⁎ Vaccum delivery 19(10%) 3(16%) 0.42 Episiotomy 73(40%) 13(72%) 0.008⁎ Perineal tears 94(51%) 11(61%) 0.443 Birth weight [gr] 3157.9±383.8 3140±412.1 0.856 ⁎ P < 0.05. CONCLUSIONS APUR was observed in 9% of women after their first vaginal delivery. Main risk factors are prolonged 2nd stage of labor and mediolateral episiotomy. APUR is most probably a self limiting phenomenon and spontaneous resolution is expected within 72 hours after delivery. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e788 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Yael Salemnic Tel Aviv, Israel More articles by this author Ronen Gold Tel Aviv, Israel More articles by this author Joseph Har Toov Tel Aviv, Israel More articles by this author Ariel Jaffa Tel Aviv, Israel More articles by this author David Gordon Tel Aviv, Israel More articles by this author Joseph Lessing Tel Aviv, Israel More articles by this author Asnat Groutz Tel Aviv, Israel More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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Salemnic et al. (2012) studied this question.