Acute urinary retention after cesarean delivery: a case-control study
Authors
Kandadai, PadmaKandadai, Venk
Saini, Jyot
O'Dell, Katherine K.
Patterson, Danielle
Flynn, Michael
UMass Chan Affiliations
Department of Obstetrics and Gynecology, Division of Urogynecology and Reconstructive Pelvic SurgeryDocument Type
Journal ArticlePublication Date
2014-09-01Keywords
Female Urogenital Diseases and Pregnancy ComplicationsMaternal and Child Health
Obstetrics and Gynecology
Women's Health
Metadata
Show full item recordAbstract
INTRODUCTION: This study aimed to identify risk factors for postpartum urinary retention (PPUR) after cesarean delivery (CD). METHODS: A case-control study design was used. Cases of PPUR after CD were identified using billing codes for CD and "urinary retention" and confirmed by chart review. Matched controls were identified in a 2:1 ratio using an obstetrics database and billing data. Patient demographics, operative, and anesthetic data were collected. Fisher exact tests and Wilcoxon rank sum tests were used to determine differences in medical risk factors, postoperative analgesic use, and catheter management between cases and controls. A modified Poisson conditional multivariate regression with robust error variances was used to estimate the odds ratios (ORs) for significant predictors. RESULTS: Thirty-four confirmed cases of PPUR were matched with 68 controls. The mean ages of cases and controls were 31 and 32 years, respectively. Cases and controls differed in gestational age (P = 0.01), diagnosis of diabetes (P = 0.05), and use of postoperative intravenous and oral narcotics (P < 0.01 and P = 0.03, respectively). In a multivariate model including these factors, increasing gestational age was associated with decreased risk of PPUR [OR, 0.07; 95% confidence interval (CI), 0.01-0.48; P < 0.01], whereas use of postoperative intravenous narcotics (OR, 4.51; 95% CI, 1.09-18.67; P = 0.038) and oral narcotics (OR, 4.99; 95% CI, 1.10-22.65; P = 0.037) were associated with increased risk. CONCLUSIONS: After matching for obstetric factors, use of postoperative narcotic analgesia was associated with increased risk of PPUR. Other operative and anesthetic factors had no association. Multicenter prospective studies are needed to investigate this association.Source
Female Pelvic Med Reconstr Surg. 2014 Sep-Oct;20(5):276-80. doi: 10.1097/SPV.0000000000000053. Link to article on publisher's siteDOI
10.1097/SPV.0000000000000053Permanent Link to this Item
http://hdl.handle.net/20.500.14038/42792PubMed ID
25181378Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1097/SPV.0000000000000053