Postpartum Urinary Retention

Nursing Knowledge

Postpartum Urinary Retention

Postpartum urinary retention is a common condition where a new birth mother experiences difficulty or inability to pass urine following childbirth. This can cause acute pain and can lead to infections. Causes include the effects of anesthesia, perineal trauma, and hormonal changes. Keep reading for the symptoms, complications, and appropriate nursing interventions for the condition.

Last updated: October 9, 2024

What is urinary retention?

Urinary retention is defined as a condition that develops when an individual cannot spontaneously void or fully empty their bladder. Postpartum urinary retention describes urinary retention following childbirth.

Types of urinary retention

Overt retention: inability to void
Covert retention: incomplete bladder emptying
Persistent retention: Postpartum urinary retention will be classified as persistent retention if it continues beyond the third postpartum day. In some cases, it can persist for several weeks.

How long does postpartum urinary retention last?

Postpartum urinary retention typically resolves within a few days. The duration can vary depending on the underlying cause and individual factors.

What causes urinary retention?

Causes and risk factors of postpartum urinary retention

Postpartum urinary retention can be caused by effects of anesthesia, pain and trauma, or the stretching of the bladder during pregnancy and childbirth. Risk factors include:

Mode and duration of labor (prolonged labor or difficult delivery)
Post-void residual bladder volume
Episiotomy/vaginal tears
Instrumental delivery (forceps or vacuum extraction)
Catheterization during labor
Birth weight and multiparity
Use of epidural anesthesia during labor
Postpartum hemorrhage

Can constipation cause urinary retention?

A full rectum can exert pressure on the bladder and potentially cause it to not be able to completely empty. In the postpartum period, this may be an additional risk factor for urinary retention since the hormonal changes and physical effects of delivery may lead to constipation.

Urinary retention after surgery

After surgeries, urinary retention can occur due to similar reasons as postpartum urinary retention: effects of anesthesia, pain medications, limited mobility, stress/anxiety, trauma and overdistension of the bladder.

Symptoms of urinary retention

Urinary retention presents with:

Inability to urinate
Urgent need to urinate
Weak or interrupted urinary stream
Feeling of incomplete bladder emptying
Abdominal discomfort or distention

Potential complications of urinary retention

Irreversible damage to bladder function
Pain
Urinary incontinence
UTI and catheter-related complications
Hydronephrosis
Kidney failure (due to renal obstruction)

Client education and interventions

Routine:
- Clients should be encouraged to follow a bladder routine (voiding every 2–3 hours).
- Provide measures that help the routine like privacy, voiding positions, or sound of running water.
- They should drink water even if they are not feeling thirsty.
- Proper perineal hygiene should be ensured to prevent infections.
Warning signs:
- Teach about signs of bladder fullness and bladder dysfunction.
- Make sure clients know when to seek medical assistance.
Assessments and support:
- Ensure proper pain management.
- Perform bladder scan as needed.
- Catheterize clients if indicated and teach proper foley catheter care.

Urinary retention nursing diagnosis

Potential nursing diagnoses for urinary retention include:

Impaired urinary elimination: monitor output, encourage and support in frequent voiding
Acute pain: aside from ordered pain management, use of nonpharmacologic pain relief like warm compresses should be encouraged
Anxiety: provide emotional support and education about the condition
Risk for infection: monitor for signs of UTIs and ensure proper perineal hygiene and fluid intake

Postpartum Nursing: Normal Changes & Nursing Diagnosis

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