Urinary problems

Question 1

What urinary problems do women in puerperium typically get?

Answer 1

Retention of urine
UTI
Incontinence

Question 2

How would retention of urine present?

Answer 2

Frequency
Stress incontinence
Severe abdo pain

Question 3

Could retention of urine go unnoticed?

Answer 3

Yes, especially if woman has an epidural

Question 4

What complications may arise from urinary retention?

Answer 4

Infection
Overflow incontinence
Persistent voiding difficulty

Question 5

How can retention be identified?

Answer 5

Use of strict fluid charts and abdo palpation

Postmicturition USS can assess residual volume

Question 6

How is retention treated?

Answer 6

Catheterisation for minimum 24hrs

Question 7

Is UTI common in puerperium?

Answer 7

10% affected
Usually asymptomatic, but in pregnancy can cause systemic infection of pyelonephritis
Routine urine culture advised

Question 8

How common is incontinence in puerperium?

Answer 8

20%

Symptoms usually improve, especially with pelvic floor exercises (although limited role as prophylaxis)

Question 9

What else should be excluded when considering incontinence?

Answer 9

Infection and overflow incontinence

Perform post-micturition USS and culture