Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 6, 2021; 9(13): 3130-3139
Published online May 6, 2021. doi: 10.12998/wjcc.v9.i13.3130
Acute urinary retention in the first and second-trimester of pregnancy: Three case reports
Lin Zhuang, Xiao-Yin Wang, Yan Sang, Jiao Xu, Xue-Lian He
Lin Zhuang, Xiao-Yin Wang, Yan Sang, Jiao Xu, Department of Obstetrics, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610000, Sichuan Province, China
Xue-Lian He, Department of Obstetrics, Sichuan Provincial Hospital for Women and Children, Chengdu 610000, Sichuan Province, China
Author contributions: Zhuang L, Wang XY, and Sang Y designed and performed most of the investigation and wrote the manuscript; Xu J and He XL performed the data analysis and contributed to data interpretation; All authors read and approved the manuscript.
Informed consent statement: Written informed consent was obtained from individual participants.
Conflict-of-interest statement: There is no conflict to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lin Zhuang, MD, Doctor, Department of Obstetrics, Hospital of Chengdu University of Traditional Chinese Medicine, No. 39 Shi-er-qiao Road, Jinniu District, Chengdu 610072, Sichuan Province, China. zhuanglin@cdutcm.edu.cn
Received: November 23, 2020
Peer-review started: November 23, 2020
First decision: December 21, 2020
Revised: January 4, 2021
Accepted: March 3, 2021
Article in press: March 3, 2021
Published online: May 6, 2021
Abstract
BACKGROUND

Acute urinary retention (AUR) is rare during pregnancy.

CASE SUMMARY

We report on three pregnant women with AUR between the 10th and 18th wk of gestation. Case 1 was first diagnosed as urinary tract infection and developed a urinary tract infection due to urinary retention caused by urethral obstruction. Case 2 had a history of previous abdominal surgery for pelvic tuberculosis, leading to severe adhesions and a persistent retroverted uterus. In case 3, healthcare providers focused on the patient’s gastrointestinal symptoms and did not investigate her inability to void. Case 1 required manual disimpaction of the uterus and the knee-chest position. The other cases required immediate catheterization. The condition resolved in cases 1 and 2; these patients had normal pregnancies. Case 3 had severe complications at the time of consultation, leading to an abortion.

CONCLUSION

Retroverted uterus is the most common cause of AUR. Prompt recognition and diagnosis are required. Clinicians should be aware of the risk factors, etiology, and clinical presentation of AUR in the first and second trimester of pregnancy.

Keywords: Urinary retention, Uterus, Incarceration, Adjuvant therapy, Diagnosis, Intervention, Case report

Core Tip: Acute urinary retention (AUR) during pregnancy can have a negative impact on maternal and fetal health. We propose a diagnostic and therapeutic algorithm for the management of AUR in the first and second trimester. A retroverted uterus is the most common cause of AUR. Clinical symptoms, physical examination, and imaging should be used for diagnosis of a retroverted gravid uterus and AUR. Treatment may include conservative measures and/or bladder decompression with an indwelling Foley catheter or manual reduction. Subsequently, the uterus should be kept anterior with a normal vesicourethral angle. Occasionally, a soft pessary or antibiotics may be used.