Postpartum Bladder Issues: Causes and Solutions

Q: Postpartum Bladder Issues: Causes and Solutions

Hello： 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 gynecological recovery is progressing well after delivery, Keg

Bladder urine volume issues?

Hello, doctor.
My issue with bladder urine volume started after I had a natural delivery.
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 delivery, my urine volume checks showed only 80-100 ml, so I underwent catheterization for about five days.
However, after the catheter was removed, there hasn't been much change; my urine volume 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 then.
I do not experience any pain while urinating, and I feel the urge approximately every two hours, with normal urine 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 not acceptable 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 my delivery.
I am currently abroad, so it is inconvenient for me to return to Taiwan for medical care, so I am seeking assistance and answers here.
Thank you.

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

Dr. Du Shixi reply Urology

Hello: 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 gynecological recovery is progressing well after delivery, Kegel exercises can be performed to strengthen pelvic floor function.
Based on your description, it does not seem to indicate a situation of 100 mL self-voiding and 300 mL residual urine.
I personally recommend maintaining adequate hydration, performing Kegel exercises, minimizing beverage intake, avoiding constipation, and most likely, normal function will be restored.
As for medications, I cannot provide recommendations in this area, and their effectiveness may not be as beneficial as Kegel exercises.
When doing these exercises, there is no need to 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

Postpartum bladder issues can be a significant concern for many women following childbirth. In your case, the symptoms you are experiencing, such as low urine output and the need for catheterization, are not uncommon, especially after a prolonged labor or the use of epidural anesthesia. Let’s break down the potential causes, implications, and solutions for your situation.

Causes of Postpartum Bladder Issues
1. Epidural Anesthesia: One of the most common reasons for urinary retention after childbirth is the use of epidural anesthesia. This type of anesthesia can temporarily numb the nerves that control bladder function, leading to difficulties in sensing the need to urinate or in fully emptying the bladder.

2. Prolonged Labor: Extended labor can lead to physical trauma or swelling in the pelvic region, which may affect bladder function. The pressure from the baby during delivery can also impact the bladder's ability to contract effectively.

3. Hormonal Changes: After childbirth, hormonal fluctuations can affect bladder function. The body undergoes significant changes, and it may take time for everything to return to normal.

4. Injury or Trauma: In rare cases, trauma during delivery can lead to nerve damage or other complications that affect bladder control.

Implications of Low Urine Output
Your reported urine output of 80-100 ml is concerning, especially if you are experiencing residual urine of 300 ml after urination. This condition, known as urinary retention, can lead to complications such as:
- Bladder Overdistension: If the bladder is not emptied regularly, it can become overstretched, which may lead to permanent damage or dysfunction.

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

- Bladder Rupture: While rare, severe overdistension can lead to bladder rupture, a serious medical emergency.

Solutions and Recommendations
1. Monitoring: It’s essential to continue monitoring your symptoms. If you notice any changes, such as increased pain, fever, or worsening urinary retention, seek medical attention promptly.

2. Hydration: Ensure you are well-hydrated, as adequate fluid intake can help stimulate bladder function.

3. Scheduled Voiding: Try to establish a routine for urination. Even if you don’t feel the urge, attempt to urinate every 2-3 hours to prevent overdistension.

4. Pelvic Floor Exercises: Engaging in pelvic floor exercises (Kegel exercises) can help strengthen the muscles involved in bladder control. This may take time, but it can be beneficial in the long run.

5. Medication: There are medications that can help stimulate bladder function, but these should only be prescribed by a healthcare provider. Since you are currently abroad, consult a local physician who can assess your situation and provide appropriate treatment.

6. Follow-Up Care: Once you are able to return home, it’s crucial to follow up with your healthcare provider. They may recommend further tests, such as a bladder ultrasound or urodynamic studies, to assess bladder function and residual urine volume.

Conclusion
While your symptoms are concerning, many women experience bladder issues postpartum, and with appropriate care and monitoring, many find that their bladder function improves over time. It is crucial to remain vigilant about your symptoms and seek medical advice if your condition does not improve or worsens. Remember, your health and well-being are paramount, and addressing these issues early can prevent complications down the line.

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