Inability to urinate after childbirth

Having a baby is a big deal, and a woman's body will also be affected by childbirth after delivery. There is a saying that the excretion function of postpartum women, especially the urination function, will be impaired to a certain extent, and it is easy to have symptoms of mental supplementation after childbirth. These patients will feel that there is urine in the body, but they cannot excrete it when they go to the bathroom, or they excrete it but not completely. What should we do if this happens?

Temporary urinary dysfunction after delivery is one of the most common complications in the early postpartum period. The mother often feels abnormal pain because of this. In severe cases, it is easy to develop complications such as urinary tract infection, bladder rupture, etc. Chinese medicine calls it "transmission" or "postpartum urinary difficulty." It often occurs within 1 to 3 days after delivery, and within 1 to 3 days after the removal of the catheter after cesarean section. It is more common in primiparas, especially those who have undergone cesarean section and episiotomy.

In the late pregnancy, the bladder is pulled by the uterus and compressed by the fetal head, which causes the tension of the bladder wall smooth muscle to decrease and the elasticity to temporarily decrease, making urination more likely to occur. For most women, their bladder urination function can gradually recover after delivery. However, some women suffer from postpartum urinary retention due to a certain degree of damage to their bladder and urethra during delivery.

The main reasons are prolonged labor due to uterine atony, transverse or posterior occipital position, breech presentation, improper labor management, etc., the fetal presenting part compresses the bladder for too long, and the bladder mucosa becomes congested and edematous. And because the overstretched lower segment of the uterus pulls the bladder too high, the bottom of the bladder also becomes congested, edematous, and even bleeding. The urethra also becomes congested, edematous, and the urethral opening is blocked. Some women have excessive urine retention before delivery (during the first or second stage of labor) and fail to deal with it in time, which further stretches the bladder, causing it to become overly tense, reduce sensitivity, and even cause nerve paralysis, which causes the bladder's urination reflex function to disappear. The above abnormal changes lead to a decrease or even temporary loss of the maternal urination function, and the patient is unable to urinate. Some mothers are temporarily unable to urinate due to nervousness, fear of people, unfamiliarity or lack of confidence in their own urination. Some women also have urination problems due to the use of various anesthetics during delivery.

In terms of diet, radish and crucian carp soup has the effect of promoting urination. Radish is a diuretic, and crucian carp promotes the secretion of milk. It can be eaten regularly after childbirth. For patients with urinary retention, catheterization should not be considered first. Every effort should be made to enable the patient to urinate on his own, and physical and drug methods should be used first.

1. Heat

Use a hot towel or hot water bottle to apply heat to the lower abdomen and urethral opening, and massage at the same time, 3 times a day, each time for 15 to 30 minutes.

2. Urine drainage

When the water in the bathroom is turned on, the sound of running water or other people's urination can stimulate the patient to urinate and cause the patient to urinate automatically.

3. Intramuscular injection of neostigmine 0.5 mg, 1 to 3 times a day, can promote the recovery of bladder smooth muscle function.

4. Acupuncture and Massage

(1) Massage the diuretic point: The diuretic point is located between the navel and the pubic symphysis. Press this point and push down toward the pubic symphysis intermittently in a counterclockwise direction, first lightly and then heavier. Do this 3 to 4 times a day, each time for 10 to 15 minutes.

(2) New acupuncture: Qihai penetrates Qugu, Sanyinjiao penetrates Xuanzhong.

(3) Acupuncture or acupoint blocking: The main acupoints are Sanyinjiao and Yinlingquan, and the auxiliary acupoints are Guanyuan and Qihai.

(4) Auricular acupuncture: bladder point.

5. Chinese medicine treatment

The principle is to warm the yang and tonify the kidney. The prescription is Guifu Bawei Decoction with modifications: 12g of cooked aconite, 1.5g of cinnamon heart, 12g of cornus fruit, 18g of Chinese yam, 12g of cooked rehmannia, 18g of poria, 12g of zeqi, and 5g of moutan bark. For those with qi deficiency, add 30g of Codonopsis pilosula and 15g of Astragalus membranaceus.

Folk remedy: 20-30g of silkworm slough, add 500-600ml of water and boil it, 1-3 times a day, the effect is good.

6. Catheterization

If the above methods are still ineffective, catheterization should be performed. The first catheterization should be 1000~1500ml. The urinary catheter should be placed and opened regularly every 3~4 hours. After 24~72 hours, the patient can generally urinate automatically. At the same time, infection should be prevented.