Post-partum urinary retention is a difficult, and somewhat frustrating condition experienced by some women following pregnancy. Currently, there is no specific definition for the condition yet it can best be described as “the inability to pass urine spontaneously”. Naturally, this can be rather embarrassing and luckily the use of catheterisation is an effective clinical treatment for this. However, indwelling catheterisation is rather invasive and includes a somewhat uncomfortable procedure which may not be appropriate for all women. A recent study found that the use of acupuncture can provide an effective alternative to indwelling postpartum catheterisation for urinary retention and results in similar bladder emptying volumes as supported by bladder sonography (1).

 

The cause of postpartum urinary retention is not fully understood, however it has been attested to the physiological changes during pregnancy and labour. The high levels of progesterone released during pregnancy and postpartum reduces smooth muscle tone resulting in dilation of the ureters and bladder. The detrusor muscle (surrounding the bladder) also has a decrease in tone and allows increased bladder size, but despite this increase in size the need to urinate often is still prominent as the weight of the uterus in pregnancy “pushes” on the bladder. However, in the immediate postpartum period much less weight is pushed onto the bladder, limiting its capacity and becoming hypotonic (Large volume but low muscle tone and almost no contractions of the bladder to allow urination) (2).

 

The total study group composed of 55 women experiencing difficulty urinating spontaneously within the postpartum period. 30 women (control group) undergone catheterisation and the remaining 25 (study group) received acupuncture from a fully licensed/trained acupuncturist with specific points chosen to aid bladder voiding. Following treatment, 96% of the control group and 92% of the study group receiving acupuncture were able to spontaneously urinate and bladder volume was successfully further confirmed using ultrasound. Additionally, none of the patients receiving acupuncture required further intervention to maintain bladder voiding until discharge.

“An open mind to alternative medicine was advantageous in our case, and may be helpful in other fields as well.”

Lauterbach,et al.

The authors conclude that acupuncture provides as “excellent non invasive option for women with postpartum urinary retention”, and allows circumvention of indwelling catheter related problems including risk of infection.  Unfortunately, the given study sample (55 women) is relatively small, an opinion also recognised by the authors; however, this study presents valuable insight into the use of acupuncture as a powerful tool in yet another clinical sector. Furthermore, the use of sham needles were rightfully excluded for ethical reasons yet this potentially complicates the ability to separate placebo from effects displayed. Nevertheless, the results displayed in this study are significant in aiding postpartum recovery and are highly promising. Further research into the use of acupuncture for postpartum urinary retention with larger cohorts would be enlightening to obstetrics and I eagerly anticipate further studies.

Photo by negativespace.co

Please note, all information presented within this blog is not a substitution for medical advice from your doctor.  Consult your doctor regarding any medical issues and appropriate treatment.

R. Marsden

R. Marsden

As a recently graduated Human Bioscience BSc student, I have a keen interest in evidence based science and the study of disease ranging from study of the molecular basis to the more visible systemic effects, and how this may impact daily life. Alongside several other areas, acupuncture remains an avid interest of mine and I enjoy evaluating current, non-biased research to pass onto this blog. 

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