ACT Health, Maternity Practice Guideline, Management of post post-Partum Urinary Retention. March 2009.

Identification & non-invasive measures

POST-PARTUM OVERT URINARY RETENTION PARTUM

DEFINITION: Symptomatic inability to void within 6 hours of birth or removal of IDC : NO VOID > 4H POST BIRTH OR R/O IDC and IDENTIFICATON OF ONE OR MORE OF THE FOLLOWING SYMPTOMS: SYMPTOMS Pain, Urgency, Hesitancy, Straining to void, Slow or intermittent stream and sense of incomplete emptying BOX 1 INSTIGATE NON-INVASIVE MEASURES INVASIVE Analgesia, running water, ambulation, double voiding, provision of privacy, warm bath, ural ENSURE ADEQUATE FLUID INTAKE START FLUID BALANCE CHART WAIT FURTHER 2 HOURS (UNTIL 6H POST BIRTH OR R/O IDC)

Stage 1

Assessment of Volumes & I/O IDC

VOID

NO VOID

VOLUME > 200mL Continue non-invasive measures (BOX 1)

VOLUME < 200mL Drain bladder with IDC and record volume

Stage 2

Send CSU for analysis

remove IDC
Volume from IDC <150 mL Volume from IDC 150 150-700 mL IDC 24 H Volume from IDC >700 mL IDC 48 H

after prescribed period of time Remove IDC Trial of void No void> 4H post r/o IDC Repeat Box 1

Wait further 2 H (Until 6H post r/o IDC)

Trial of Void

Stage 3

Spontaneous void> 200mL

No Spontaneous void or void < 200mL Insert IDC and measure volume

Residual volume via IDC >150mL Move to Covert Urinary Retention Pathway Commence 2 Hourly Timed Voiding

Residual volume via IDC <150 mL No Further Action Residual volume via IDC : 150-700mL IDC 24 HRS Residual volume via IDC >700mL IDC 48 HRS

after prescribed period of time Repeat trial of void