Rx of increased post voidal - zkadhem

[ArchivalUser]

I think vacant_planets2000 is right...
here I quote from Up To Date....

Postpartum urinary retention is a relatively common complication in the early puerperium. There is no standard definition, but the absence of spontaneous micturition within six hours of vaginal delivery or within six hours of removal of an indwelling catheter after cesarean delivery are reasonable criteria . In a large series of over 11,000 postpartum patients, the prevalence of postpartum urinary retention defined as inability to void for at least 12 hours after vaginal delivery was 0.45 percent . When inability to void six hours after delivery and residual urine volume of >150 mL was used as criterion, the prevalence was 4 percent . The prevalence of voiding dysfunction symptoms (eg, hesitancy, slow or intermittent stream, straining, sense of incomplete emptying) is much higher.

[ArchivalUser]

Postpartum urinary retention appears to be due to injury to the pudendal nerve during the birth process. Prolonged pudendal nerve terminal motor latency has been demonstrated after delivery and lasts for two to three months postpartum [35-37]. Some women may have longterm dysfunction. (See "Pelvic floor disorders associated with pregnancy and childbirth").

[ArchivalUser]

Risk factors include nulliparity, instrument assisted delivery, prolonged first and second stages of labor, cesarean delivery, and possibly epidural anesthesia [38].

[ArchivalUser]

The initial treatment of urinary retention can be noninvasive, such as use of oral rather than parenteral analgesics, helping the patient to a bathroom instead of using a bedpan, providing privacy, taking a warm bath, or immersion of the woman's hands in cold running water . Pharmacological therapies have not be shown to be effective for postpartum urinary retention; if noninvasive measures don't work, then catheterization is indicated if the bladder can be palpated abdominally and the woman is unable to void or she voids only small amounts suggestive of overflow. The volume of urine drained may help in decision making regarding leaving an indwelling catheter for 24 hours or intermittent catheterization, as necessary. In one small study, as an example, repeat catheterization was needed in 1/10 postpartum women with urine volume <700 mL, 2/14 with 700 to 1000 mL, and 5/25 with >1000 mL .

[ArchivalUser]

It is reasonable to discontinue catheterization when the residual urine volume is <150 mL and the patient no longer has significant symptoms of voiding difficulty. These criteria are empiric, there is no evidence based standard . Urinary retention is a self-limited disorder that can be expected to resolve within one week in most patients ]. Long-term sequelae have not been described.