Postpartum Urinary Retention: Can’t pee after you had a vaginal delivery?
This is a rather common condition post vaginal delivery. Often related to prolonged labor, tearing or perineal lacerations, episiotomy (surgical cut made at the vagina during childbirth), or having a big baby! Postpartum urinary retention (PPUR) is defined as having residual volume of more than 150mL of liquid in your bladder or the inability to pee (void) within 6 hours after vaginal delivery (Cavkaytar, 2014).
Why does this happen?
Western Perspective
The pathophysiology is still unclear. However, according to researchers, it may be due to multiple things like physiological, neurological and the mechanical process of vaginal delivery.
TCM Perspective
In TCM, there are 12 major pathways that runs bilaterally and 2 pathways that runs centrally in the front and back of your body. These different pathways have significance in what it controls. Before I lose you, let’s just focus on the obvious thing here. Your bladder. Changes in your body such as the pressure on your bladder while carrying a baby and the changes that occur after delivering your baby are some obvious justifications. In TCM, the front and back pathways namely Ren and Du channels have a regulatory effect in how you "hold onto” the essence and energy within you. With overstrain, you’re pushing more out than you are intended as such you may become deficient. Now, your bodily response is to hold onto whatever you can. The Urinary Bladder (UB) channel is found on the back of your body and as the name implies, in a lot of ways regulate your urinary function. The UB may become more deficient leading to back pain and challenges in regulating your urination capabilities. Note, these are very generalized explanations and every person is different.
How are you diagnosed & what happens if it is not treated?
Alongside with the symptoms mentioned above, diagnosis is through sonographic estimation of bladder volume, though deemed controversial due to technical and and anatomical issues. If PPUR goes unnoticed or untreated, it may lead to bladder dysfunction, urinary tract infection (UTI), and catheter-related complications. Postpartum urinary retention may also damage the detrusor muscle and the parasympathetic nerves of the bladder wall which can affect the detrusor function.
What treatments are available?
The conventional treatment is with a catheter. From a TCM approach, MOXA and acupuncture are key and application of herbal supplements may also be recommended.
What you can expect is with the subsequent visits, the volume of your voids would increase. It is recommended to do treatments two to three times a week with consistent at home moxa.
