Is Postpartum Urinary Retention a Neurogenic Phenomenon?

Postpartum urinary retention (PUR) can be classified as covert, those with postvoid residuals higher than 150 cm³, or overt, those unable to void 6 hours after vaginal delivery or after removal of a catheter after cesarean section. There is limited data and research on the mechanism of PUR. However, it has been suggested that there is a neurological component to the development of PUR. This includes disruption of the afferent system through analgesic blockade, crush or stretch injuries to the pudendal nerve during delivery, and impairment of neurotransmitters required for proper signal transduction. However, it is likely that the causes of PUR are multifactorial, and that physiologic changes of pregnancy and trauma from childbirth play a critical role.