Acute Postpartum Urine Retention: Case Report and Review of the Literature

Abstract

Introduction: Acute postpartum urine retention is a condition whose failure to recognize it can lead to delays in diagnosis, which can worsen the progno-sis, and to inappropriate management. It occurs in 0.7% to 0.9% of vaginal de-liveries. Its aetiology is multifactorial. There are many risk factors. Treatment is based on intermittent evacuation catheterization. Today, there is no con-sensus on the management of this condition, which has received little atten-tion in African literature. Hence the interest of this article. Clinical Case: This is a 46 years old female, G5P5 005, with no prior history of involvement, who, after a dystocic vaginal delivery (longer than 12 hours with long foetal expul-sion) and at term of a female newborn weighing 3475 g, developed hypogastric pain and spontaneous failure to urinate within 24 hours of delivery. The phys-ical examination revealed abdominal tenderness and dullness with a strong desire to urinate and a normal neurological examination. The diagnosis was postpartum urinary retention. A bladder catheter inserted through the urethra drained 1100 ml of clear urine. Management consisted of physical measures and the prescription of an alpha blocker (Alfuzosin 4 mg). Two days later, the patient urinated normally. Conclusion: Acute postpartum retention in rou-tine practice is rare but may be underestimated. Measures need to be taken to diagnose and manage this complication and also to determine the epidemiology of this postpartum complication.