The Prevalence of Long-Term Lower Urinary Tract Symptoms Among Women Who Previously Experienced Postpartum Urinary Retention—A Cross Sectional Study

TL;DR

This study found that most women who had postpartum urinary retention did not experience long-term urinary issues, though a few risk factors were linked to ongoing problems.

Contribution

The study identifies hypothyroidism and postpartum uterine atony as novel risk factors for long-term voiding dysfunction after postpartum urinary retention.

Findings

Most women with postpartum urinary retention did not report long-term urinary symptoms.

Voiding dysfunction was associated with hypothyroidism and postpartum uterine atony.

Common PPUR risk factors like nulliparity and epidural analgesia were less common in those with long-term voiding dysfunction.

Abstract

Background: Postpartum urinary retention (PPUR) typically resolves within the first three days following delivery. However, in rare instances, it may persist beyond 72 h and, in some cases, extend for several weeks. The current study aimed to evaluate long-term sequelae in women who endured PPUR following vaginal delivery. Methods: Between January 2013 and December 2019, 362 women who experienced PPUR following delivery at our institution were identified and subsequently invited to complete the UDI-6 questionnaire that serves to assess lower urinary tract symptoms. The questionnaires were filled out and returned by 242 women (66.8%). Results: Participants who had no urinary complaints (145/242; 60%) were assigned to Group 1. Of the 97 women allocated to Group 2 (97/242; 40%), 96 reported only mild urinary symptoms, while just 1 individual scored above the threshold of 33.3, suggesting elevated urinary distress. Risk factors known to be associated with PPUR were equally distributed among the two groups. A predominance of Caucasians was noted in Group 2 (p = 0.012). Voiding dysfunction (question 5 of UDI-6), taken separately, was proclaimed by 15 women from Group 2 (15/97 = 15.5%). When these were compared to the rest of the cohort (n = 227), an association with hypothyroidism was recognized (p = 0.036). Well-established risk factors for PPUR, such as nulliparity and epidural analgesia, were observed less frequently among women with persistent voiding dysfunction (p = 0.045 and p = 0.049, respectively), while postpartum uterine atony was more frequent (p = 0.047). Significant long-term effects after PPUR are uncommon. Conclusions: Hypothyroidism and postpartum uterine atony emerge as risk factors allied to long-term voiding dysfunction.