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What causes post delivery urine retention?

Q: I delivered my first baby earlier this month. It was normal delivery, due to prolonged labour of 15 hours, they gave me epidural, which was topped up twice after that. After the delivery, I developed urine retention. I was put on catheter during discharge. My urine routine was 10-15 pus cells and the culture didn't reveal anything. Could it be because I was on antibiotics on and off? What could be the reason for this problem? How can this be managed? Currently I have been asked to go for clamping, urge based. What is my prognosis and how long will I take to recover?

A:Post delivery retention of urine is not a rare occurrence. It occurs due to inability of bladder muscles to contract and muscles sometimes take a long time to recover. Neither a prolonged catheterisation nor intermittent clamping are desirable in such condition, as these manoeuvres can cause serious bladder and whole body infections (systemic sepsis). First step in management is a thorough examination and bladder physiologic evaluation with urodynamic study. Inability of bladder contraction, once proved, is treated with clean intermittent catheterisation and help of some bladder contracting medications. All these cases recover, though the recovery may take long, even upto 10 to 12 weeks.

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