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Re: Urinary Retention Postpartum From: ainsron (ainsron@sbcglobal.net) Sun Apr 18 18:57:53 2004 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Garry E. Siegel, M.D.: "Re: OB: Keepsake ultrasounds" Previous message: ainsron: "Re: Urinary Retention Postpartum" In reply to: Richard Chudacoff, MD: "Re: Urinary Retention Postpartum" Next in thread: ainsron: "Re: Urinary Retention Postpartum" That is what she is doing Ronald E. Ainsworth -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Richard Chudacoff, MD Sent: Saturday, April 17, 2004 3:10 PM To: Multiple recipients of list OB-GYN-L Subject: Re: Urinary Retention Postpartum Personally, I would teach her intermittent self catheterization, and have her continue until she has a consistent residual of less than 50 cc Richard Chudacoff, MD To take refuge with an inferior is to betray one's self. Peter Nivio Zarlenga -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Gerald P. Rodríguez Sent: Saturday, April 17, 2004 5:01 PM To: Multiple recipients of list OB-GYN-L Subject: Re: Urinary Retention Postpartum I think one would have a problem keeping a suprapubic catheter in for that long. In my experience they tend to get plugged up, don't drain well at times, etc. I also like the idea of having the bladder at complete "rest" for an extended period of time. Would anyone think of doing a quick cysto on this lady, just to make sure she doesn't have a bladder polyp/stone that may be the culprit?? She could possibly also have something unusual going on with her urethra--after all she did have a long 2nd stage and an operative delivery. BTW, Ron, what is "CLE?" Gerald P. Rodríguez, M.D., FACOG Santa Fe >----- Original Message ----- From: "Steve & Eryl Raymond" <eryl@intekom.co.za> To: "Multiple recipients of list OB-GYN-L" <ob-gyn-l@dns.obgyn.net> Sent: Saturday, April 17, 2004 2:40 PM Subject: Re: Urinary Retention Postpartum > I agree that you shouldn't give up, though I don't think the right way to do it > is with continuous drainage. I would suggest a suprapubic which she can empty > after each voiding so as to allow the normal filling and emptying of bladder > intermittently and at the same time see how the residuals improve. Four to six > weeks of this treatment should see a considerable improvement. At the same time > as saying this I can point to no RCT or EBM on this. > Steve > > Gerald P. Rodríguez wrote: > > > "Never" is such an ugly word, Ron. Don't give up yet. I would suggest > > trying 4 weeks of continuous Foley drainage, followed by one week of > > Urecholine (bethanechol chloride) with the Foley still in place, followed by > > Urecholine at max doses and intermittent self-cath. This is an extreme > > case, and may not work, but you have nothing to lose. > > > > Gerald P. Rodríguez, M.D., FACOG > > Santa Fe > > >> > ----- Original Message ----- > > From: "Dr. Ainsworth" <ainsron@sbcglobal.net> > > > >>I saw a patient recently who was delivered by another physician, CLE, > >>prolonged 2nd stage, VE assisted delivery. She had postpartum urinary > >>retention, requiring a foley catheter until discharge. When the > >>catheter was removed on the second postpartum she was sent home. 3d > >>later she saw me for incontinence, she had a residual of >4000cc. It > >>has now been 4wks, she is still doing intermittent self-catheterization, > >>voiding 50-100cc, residuals of 150 to 400cc. What is her prognosis for > >>normal voiding? Anyone have any experience with similar situations? When > >>I discussed this with a urogynecologist, he felt she will never void > >>normally, saying that overdistention to that degree will cause permanent > >>damage to the small nerve endings in the bladder. Thanks. Ron > > > Next message: Garry E. Siegel, M.D.: "Re: OB: Keepsake ultrasounds" Previous message: ainsron: "Re: Urinary Retention Postpartum" In reply to: Richard Chudacoff, MD: "Re: Urinary Retention Postpartum" Next in thread: ainsron: "Re: Urinary Retention Postpartum"

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