Acute urinary retention in the first and second-trimester of pregnancy: Three case reports

doi:10.12998/wjcc.v9.i13.3130

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World Journal of Clinical Cases

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World J Clin Cases. May 6, 2021; 9(13): 3130-3139
Published online May 6, 2021. doi: 10.12998/wjcc.v9.i13.3130

Table 1 Case series

Case	Year	GA	MG	Risk Factors	Symptoms	Treatment and outcome
1	2012	G3P1	31	None	Constipation, tenesmus, fatigue, vulva edema renal failure	Indwelling catheter; miscarriage
2	2018	G1P0	27	IVF-ET, prior abdominal surgery for TB	Urinary retention	Intermittent; self-catheterization; herbs; normal pregnancy
3	2018	G2P0	31	None	Urine frequency and urgency, urinary retention	Manual reduction, knee-chest position; herbs. Normal pregnancy

GA: Gestational age; IVF-ET: In vitro fertilization/embryo transfer; MG: Maternal age; TB: Tuberculosis.

Table 2 Summary of case reports of acute urinary retention in early and second trimester pregnancy in the English language literature (between 1980 and 2018)

Ref.	Year	Case	MA, G/P	Risk factor	Reason	GA in wk	Presentation	Treatment	Outcome
Goldberg et al[4]	1981	1	29/G4P2	None	Prolapsed, progressive protrusion of gravid cervix out of the vestibule	10	AUR	IDC; cystoscopy; pessary	No recurrence
Chauleur et al[7]	2008	2	1^st: 33, G2P0; 2^nd: 41, G1P0	Fibroid	Fibroid incarceration	1^st: 5; 2^nd: 6	1^st: AUR; 2^nd: Frequent and urgent, small volume urination	Myomectomy	1^st: Miscarriage; 2^nd: Normal pregnancy
Kubota et al[3]	2012	1	31/not mentioned	Protrusion of the meninges	ASM	28	Dysuria	ISC	CS at 35 wk
Nelson et al[26]	1986	1	30/G3P2		Incarcerated uterus	14	Dysuria and abdominal pain	IDC MR	An uneventful pregnancy
Yang et al[13]	2004	5	31 (range, 25-37)/3 cases: G2P1; 2 cases: G1P0	Not mentioned	Not mentioned	11-14	All AUR	Water-limiting before sleep, prone position for a while before urination, leaning forward when initiating voiding, avoiding any Valsalva	No voiding problems after 16^thwk
Lam et al[27]	2015	1	31/G5P1	RUTI, laparoscopy for PID	Incarcerated uterus	18	Urinary frequency and urgency, dysuria	Antibiotics, IDC	An uncomplicated pregnancy
Heazell et al[8]	2004	1	33/G3P2	None	Cervical pregnancy	8	AUR, abdominal pain and vaginal bleeding	Emergency evacuation, laparotomy	Hysterectomy
Newell et al[15]	2014	2	1^st: 41/G1P0; 2^nd: 33/G2P1	None	Retroverted uterus with incarceration	1^st: 17; 2^nd: 14	1^st: UR and constipation; lower limb edema and hypertension. 2^nd: UR	1^st: MR; 2^nd: ISC	1^st: Fetal death after reduction; 2^nd: An uncomplicated pregnancy
Slama et al[23]	2015	3	1^st: 37/G6P2; 2^nd: 42/G5P3; 3^rd: 22/G15P5	None	Uterine incarceration	1^st: 13; 2^nd: 13; 3^rd: 21	1^st: UR; 2^nd: UR; 3^rd: UR, nausea	1^st: ISC, Pessary; 2^nd: ISC, Pessary; 3^rd: Pessary	Symptoms alleviation
Inaba et al[25]	2005	2	1^st: 27/G1P0; 2^nd: 32/G3P0	1^st: Prolapse uterus IVF; 2^nd: Endometriosis	Uterine incarceration	1^st: 11; 2^nd: 14	1^st: UR; 2^nd: UR	1^st: KCP, MR; 2^nd: MR many times	1^st: no recurrence; 2^nd: not relieved, uterine rupture at 34 wk, CS
Danis et al[12]	2015	1	25/G1P0	None	Retroverted uterus without incarceration	18	UR	MR, colonoscopy-assisted rectosigmoid insufflation	An uneventful pregnancy
Kim et al[6]	2018	2	1^st: 34/multiparous; 2^nd: 31/primigravid a	Adenomyosis and myoma	Incarceration of uterus	1^st: 7.2; 2^nd: 6	1^st: UR; 2^nd: UR	1^st: MR, pessary; 2^nd: IDC, MR	1^st: An uncompleted pregnancy; 2^nd: A spontaneous abortion
Dierickx et al[21]	2011	4	1^st: 39/G1P0; 2^nd: 29/G1P0; 3^rd: 28/G3P2; 4^th: 34/G2P1	1^st: Endometriosis; 2^nd: Deep sacral concavity with prominent promontorium; 3^rd: None; 4^th: None	Incarcerated uterus	1^st: 22; 2^nd: 22, 25; 3^rd: 15; 4^th: 18	1^st: UR and abdominal pain; 2^nd: Dysuria and incomplete bladder emptying; 3^rd: UR; 4^th: Mictalgia	All sigmoidoscopy1^st, 3^rd, 4th: Successful; 2^nd: 22 wk successful/25 wk not successful, laparotomy	1^st and 3^st: Vaginal delivery at term; 2^nd and 4^th: CS at term
Yohannes et al[24]	2002	1	Not mentioned/G2P1	None	Incarcerated uterus	15	UR and abdominal pain	IDC, MR, KCP	No urologic problem
Suzuki et al[28]	2009	2	1^st: 26/G1P0; 2^nd: 26/G1P0	None	Retroverted uterus	1^st: 12; 2^nd: 12	1^st: UR; 2^nd: UR	Both: IDC, limiting fluid intake before sleep; prone position for a while before urination
Smalbraak et al[5]	1991	4	1^st: 31/G2P1; 2^nd: 28/G2P1; 3^rd: 26/G2P0; 4^th: 34/G2P1	None	Retroverted uterus	1^st: 15; 2^nd: 12, 25; 3^rd: 16; 4^th: 14	1^st: UR and abdominal pain; 2^nd: Abdominal pain and micturition; 3^rd: Unpalpable uterine fundus; 4^th: Micturition, abdominal pain	1^st: IDC MR; 2^nd: None; 3^rd: MR; 4^th: Antibiotics	1^st: A normal pregnancy; 2^nd: CS at term for breech presentation; 3^st: CS at 32 wk
Martínez-Varea et al[22]	2013	1	35/G7P1	Uterine prolapse (grade 2)	Uterine prolapse	14 + 3	Hypogastric pain, unable to void urine	IDC, Arabin ceralage pessary	No urologic problem
Hamod et al[17]	2002	1	27/G1P0	Fundal fibroid	Incarcerated Uterus	18	Urinary frequency, passing small volumes of urine	ISC; antibiotics for fibroid degeneration	CS at 36 wk

ASM: Anterior sacral meningocele; AUR: Acute urinary retention; CS: Cesarean section; GA: Gestational age; IDC: Indwelling catheter; ISC: Intermittent self-catheterization; IVF: In vitro fertilization; KCP: Knee-chest posture; MA: Maternal age; MR: Manual reduction; PID: Pelvic inflammation disease; RUTI: Recurrent urinary tract infection; UR: Urinary retention.

Citation: Zhuang L, Wang XY, Sang Y, Xu J, He XL. Acute urinary retention in the first and second-trimester of pregnancy: Three case reports . World J Clin Cases 2021; 9(13): 3130-3139
URL: https://www.wjgnet.com/2307-8960/full/v9/i13/3130.htm
DOI: https://dx.doi.org/10.12998/wjcc.v9.i13.3130