Incidence, risk factors and diagnostic accuracy of clinical palpation in picking up post-void residual urine in postnatal women

Abstract

Purpose: To determine the incidence of covert and overt postpartum urinary retention after vaginal delivery and the associated risk factors for postpartum urinary retention. To determine how well clinical examination by abdominal palpation correlates with ultrasound findings of urinary retention.

Methods: Patients after delivery were screened with ultrasound and examined clinically to check for retention of urine after voiding.

Results: A total of 822 of women were recruited in the study of which 86 (10.5%) women had significant post-void residue of urine. 33 (38.4%) had overt retention, while 53 (61.6%) had covert retention. Duration of labour and an increased VAS score were found to be significantly higher among those with urinary retention. Using clinical examination to diagnose postpartum urinary retention had a sensitivity of 66.1%, specificity of 88.6%, positive predictive value of 76.5% and negative predictive value of 82.3%.

Conclusions: Clinical examination by abdominal palpation is not a very sensitive test in diagnosing PPUR.

Keywords: Postpartum; clinical palpation; retention of urine.