Abstract
Purpose
The aim of this prospective study is to assess factors related to post void residual (PVR) and lower urinary tract symptoms in the second trimester of pregnancy, and the postpartum of women who presented normal bladder function before and until the second trimester of their pregnancies and delivered vaginally.
Methods
Pregnant women planning vaginal delivery who presented no bladder function problems before the present pregnancy and until the second trimester of their pregnancies (PVR of less than 50 ml) were selected for this study. PVR was measured using an ultrasonography device. PVR was measured once during pregnancy (24th to 27th week); once every day from day 1 to 5 and once at one month postpartum. In addition, participants completed a questionnaire about lower urinary tract symptoms. Statistical analysis conducted were the t-test for independent sample, Pearson's Chi-squared test,
Results
Covert urinary retention (CUR) occurred in 18.5% of participants in their first day postpartum and in 30.8%, 24.6% and 15.4% of women in their third, fourth and fifth day postpartum respectively. After 1 month postpartum all participants presented a less than 50 ml PVR. Lower tract urinary symptoms (LUTS) reported by the participants were: reduced bladder sensation (72.3%), straining to void (55.4%), feeling of incomplete emptying (29.2%) and urinary incontinence (7.7%). Reduced bladder sensation, feeling of incomplete emptying and straining to void decreased to about 10% in the first month postpartum (p<0.01). However, urinary incontinence increased from 7.7% in the first day postpartum to 15.4% in the fourth postpartum day (p<0.05) and remained unchanged after one month. None of the studied factors were found to be related to CUR, however, baby weight at birth was related to straining to void (p<0.01). There was significant relation between LUTS and the 4th and one month postpartum (p<0.05). The group experiencing CUR at 4th day postpartum presented a highly significant (p<0.01) incidence of urinary incontinence.
Conclusion
While CUR was present at 4th day postpartum in up to 24.6% of participants, it disappeared completely at one month postpartum. LUTS such as reduced bladder sensation, straining to void, feeling of incomplete voiding and urinary incontinence persisted. Although the present study could not clarify factors related to CUR, the analysis showed that baby weight at birth was significantly related to straining to void. In addition, LUTS reported during the 4th days were significantly related to LUTS at one month postpartum. CUR at 4th day postpartum was significantly related to urinary incontinence at one month postpartum.
