Low Urine Output After Childbirth: Causes and Concerns

Q: Low Urine Output After Childbirth: Causes and Concerns

Hello： Please note that this response is for reference only and cannot replace a physician's examination. <br>Difficulty urinating after childbirth is quite common, as both pregnancy and the delivery process can have an impact. <br>If your gynecological recovery is progressing we

The urine output does not exceed 100 ml each time?

Hello, doctor.
My issue with bladder urine volume started after I gave birth naturally.
The obstetrician mentioned that it could be a side effect of the epidural anesthesia or that the prolonged labor may have caused some pressure.
After giving birth, my urine volume checks showed only 80-100 ml, so I was given a urinary catheter for about five days.
However, after the catheter was removed, there hasn't been much change; my urine volume still remains at 100 ml or below! I only experienced two instances of urgency in the morning, where I urinated 150 ml and 200 ml, but I haven't reached those volumes again since.
I don't feel any pain while urinating, and I experience the urge to urinate approximately every two hours, with normal flow.

I would like to know if this is considered normal.
Will it resolve on its own? If left untreated, could it lead to bladder rupture? Previously, the gynecologist tested how much urine was left in my bladder after I urinated 100 ml, and it showed 300 ml remaining.
The doctor said this was concerning and that ignoring it could likely lead to bladder rupture...
Is this true? Are there any medications I can take? It has been 17 days since I gave birth.
I am currently abroad, so it is inconvenient for me to return to Taiwan for medical care, which is why I am seeking assistance here.
Thank you.

Qi, 30~39 year old female. Ask Date: 2021/08/05

Dr. Li Minghui reply Urology

Hello: Please note that this response is for reference only and cannot replace a physician's examination.
Difficulty urinating after childbirth is quite common, as both pregnancy and the delivery process can have an impact.
If your gynecological recovery is progressing well after delivery, you can perform Kegel exercises to strengthen pelvic floor function.
Based on your description, it does not seem to indicate a situation of 100 mL of self-voiding and 300 mL of residual urine.
I personally recommend maintaining adequate hydration, performing Kegel exercises, minimizing beverage intake, avoiding constipation, and most likely, you will return to normal.
Regarding medications, I cannot provide recommendations in this area, as their effectiveness may not be as beneficial as Kegel exercises.
When doing these exercises, do not rush; performing them 3-4 times a day is sufficient, and the effects will gradually become noticeable.
If you need to measure residual urine volume, it may be necessary to seek medical evaluation.
Wishing you a speedy recovery to good health.

Reply Date: 2021/08/05

More Info

Low urine output after childbirth can be a concerning issue, especially when it persists beyond the immediate postpartum period. In your case, it seems that you are experiencing significantly reduced urine output, with measurements consistently around 80-100 ml, which is quite low. Let's explore the potential causes, implications, and recommendations for your situation.

Causes of Low Urine Output Postpartum
1. Anesthesia Effects: As you mentioned, the use of epidural anesthesia during labor can lead to temporary urinary retention. This is due to the numbing effect on the nerves that control bladder function, which can result in decreased sensation and muscle control.

2. Bladder Overdistension: If the bladder becomes overly full, it can lead to a condition called bladder overdistension. This can occur if the urge to urinate is not felt or if the bladder is not emptied regularly. The fact that you had a post-void residual of 300 ml indicates that your bladder is not emptying completely, which can lead to further complications.

3. Labor and Delivery Trauma: Prolonged labor or trauma during delivery can affect the pelvic floor muscles and nerves, leading to issues with bladder control and function.

4. Hormonal Changes: After childbirth, hormonal fluctuations can also affect kidney function and fluid balance, potentially leading to changes in urine output.

Concerns and Risks
- Bladder Rupture: While bladder rupture is a rare complication, it can occur if the bladder is severely overdistended and not emptied. Your doctor’s warning about the risk of bladder rupture is valid, especially considering your residual urine volume. It is crucial to monitor your symptoms closely.

- Infection: Retaining urine can increase the risk of urinary tract infections (UTIs), which can further complicate your recovery.

Recommendations
1. Monitoring: Keep a close eye on your urine output. If it continues to remain low, or if you experience any pain, fever, or other concerning symptoms, it is essential to seek medical attention.

2. Hydration: Ensure you are adequately hydrated. Sometimes, increasing fluid intake can help stimulate urine production.

3. Bladder Training: If you are able to, try to establish a regular schedule for urination, even if you do not feel the urge. This can help retrain your bladder.

4. Medications: While there are medications that can help with bladder function, it is essential to consult a healthcare provider before starting any new medication, especially since you are currently abroad and may have limited access to your usual healthcare providers.

5. Follow-Up: Once you are able to return to your home country, it is crucial to follow up with a healthcare provider. They may recommend further evaluation, such as urodynamic studies, to assess bladder function more comprehensively.

Conclusion
In summary, while low urine output postpartum can be a temporary issue, it is essential to monitor the situation closely. Given your current symptoms and the potential risks involved, it is advisable to seek medical attention as soon as possible, especially if your urine output does not improve or if you develop any new symptoms. Your health and well-being are paramount, and addressing these concerns early can help prevent complications.

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