Purpose

The purpose of this study was to reveal facts about lower urinary tract symptoms and urinary bladder volume in the third trimester and early puerperium and to explore characteristics of lower urinary tract functions in the early puerperium.

Methods

A prospective observational study was conducted in women with singleton pregnancy going through vaginal delivery during their third trimester and early puerperium (Days 1–5 of puerperium). In the third trimester, self-administered questionnaire survey using CLSS and ICIQ-SF was conducted along with measurement of residual urine volume. In the early puerperium, subjective bladder sensation and urinary bladder volume were investigated once daily before urination and residual urine volume as well as presence or absence of difficulty in urination, feeling of incomplete emptying and urinary incontinence after urination. Urinary bladder volume and residual urine volume were measured using a portable ultrasound device and presence or absence of reduction in bladder sensation was classified by comparing urinary bladder volume and subjective bladder sensation. This study was conducted with an approval from the ethics committee for “human subject researches” of Toyama Prefectural University.

Results

A total of 23 subjects were included in the analysis. In the third trimester, prevalence of lower urinary tract symptoms was the highest for daytime frequency and nocturia at 87.0%, followed by urinary incontinence and urinary urgency. The mean ICIQ-SF score was 5.0±3.9.

The mean urinary bladder volume in the early puerperium was 375.8–447.7 ml. The urinary bladder volume tended to be high at 447.7±193.5 ml in Day 4, and 47.6% of the subjects had more than 500 ml. The prevalence of lower urinary tract symptoms was the highest for reduction in bladder sensation; It was reduced from 52.9% in Day 1 to 36.4% in Day 3 but increased to 42.9% in Day 4. There was no association observed between the number of days of puerperium and lower urinary tract symptoms. A logistic regression analysis revealed that the higher the ICIQ-SF score in the third trimester, the more prominent the reduction in bladder sensation in Day 4 (p=0.046, odds ratio 1.35).

Conclusion

In the early puerperium, the women may have increased amount of urine volume while experiencing reduction in bladder sensation regardless of the number of days in puerperium; the bladders are likely to become full. The ICIQ-SF score in the third trimester was associated with the presence of bladder sensation in Day 4 of puerperium.