February 18, 2021 February 18, 2021/
Post partum urinary retention (PPUR) is defined as the inability to urinate within 6 hours of giving birth. More clinically it is defined as more than 150 ml of urine being left behind in the bladder after urinating. If your bladder does not expel the urine your bladder will stretch. If it stretches too much and left untreated this can lead to sometimes irreversible bladder muscle and nerve damage, which could mean permanent catheter use to urinate. It can resolve spontaneously but can persist for months. Immediate diagnosis and management is vital.
“Immediate diagnosis and management is vital.”
“Nerves can be damaged with child birth, episiotomies and tears which can reduce bladder function.” When your baby has just been born, you may be unaware of any symptoms. That is why the medical staff supporting you need to check that you wee (urinate) within 6 hours of your babies birth. Make them aware if you have any concerns that you haven’t urinated. Your medical staff can also check your bladder fullness by palpating your bladder. An ultrasound to see how full your bladder is after urinating can be performed but is less reliable soon after birth due to the enlarged uterus in the way. Signs you can look out for are:
“check that you wee (urinate) within 6 hours of your babies birth. ” If urinary retention becomes a persistent problem a cystoscopy can be performed by a Urologist (a Doctor specialising in urinary issues) to assess whether there is any bladder nerve damage. Hopefully it does not come to this. What are the risk factors for urinary retention?
This risk can be increased by a:
“catheterise you to protect the bladder for 2 to 3 days, giving the bladder and other issues time to recover”
“Practising relaxation exercises, deep breathing and visualising the pelvic floor muscles relaxing can help voiding” YES if the retention is due to swelling, constipation, progesterone changes but it is, UNCERTAIN if retention is due to bladder trauma, nerve damage or prolonged opiate pain relief is used. SummaryPost partum urinary retention is a fairly common and potentially devastating post birth complication. Early detection and treatment is vital- make sure you have voided successfully within 6 hours of your baby’s birth. If you have had a big baby, long second stage, epidural or opiate pain relief, episiotomy, perineal tears or instrumental delivery keep an eye out for symptoms. If you are still suffering from voiding issues after discharge follow up with your doctor, nurses or women’s health physiotherapist. References
Melli Tilbrook is the Director and Physiotherapist of Mummyotherapy and also practices Physiotherapy and Pilates at Milkwood Studio, Tusmore February 18, 2021/ |