Postpartum Urinary Retention: An Expert Review

Document Type

Journal Article

Publication Date



American journal of obstetrics and gynecology




bladder protocol; female pelvic medicine and reconstructive surgery; indwelling urethral catheter; intermittent self-catheterization; intrapartum bladder management; patient education; peripartum; postpartum bladder management; urogynecology


Postpartum urinary retention is a relatively common condition that can have a significant impact on women in the immediate days following childbirth. If left untreated, postpartum urinary retention can lead to repetitive overdistention injury that may damage the detrusor muscle and the parasympathetic nerve fibers within the bladder wall. In rare circumstances, postpartum urinary retention may even lead to bladder rupture, which is a potentially life-threatening yet entirely preventable complication. Early diagnosis and timely intervention are necessary to decrease long-term consequences. There are three types of postpartum urinary retention: overt, covert, and persistent. Overt retention is associated with an inability to void, while covert is associated with incomplete bladder emptying. Persistent urinary retention continues beyond the third postpartum day and can persist for several weeks in rare cases. Recognition of risk factors and prompt diagnosis is important for proper management and prevention of negative sequelae. However, lack of knowledge from providers and patients alike creates barriers to accessing and receiving evidence-based care and may further delay diagnosis for patients, especially those who experience covert postpartum urinary retention. Nationally accepted definitions and management algorithms for postpartum urinary retention are lacking, and development of such guidelines is essential for both patient care and research design. We propose intrapartum recommendations and a standardized postpartum bladder management protocol that will improve patient outcomes and contribute to the growing body of evidence-based practice in this field.


Obstetrics and Gynecology