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Re: PP Urinary retentionFrom: STEWART PRINGLE (100724.2333@CompuServe.COM)Sat Sep 28 10:15:35 1996
Sorry, to be late on this one. Just catching up on 2 weeks mail. (Does everyone do that or am I just disorganised?) I would be concerned that your lady has a chronic voiding problem and I wonder if the management of her bladder at the time of her first delivery ( and epidural ) contributed. There is good evidence that it takes many hours for bladder sensation to return ( after elective C/S under epidural) - 9 hours, > 1000mls urine produced. Another reason that I disagree with removing the Foley after a C/S incidentally. I would agree that a suprapubic catheter for a couple of weeks then urodynamic studies if she retains again would be appropriate. Thereafter clean, intermittent self-catheterisation may be the best bet. Anecdotally, at least one senior urologist at a urogynecology meeting I attended last week, said that those women with large thin walled bladders that voided infrquently were the ones most at risk of post operative blaader fistulae so watch out for the future!
-- Stewart Pringle Specialist Registrar Southern General Hospital Glasgow, UK 100724.2333@compuserve.com
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