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No cathader used during pregnancy with epidural...
by Peronk, Sep 21, 2008 08:00PM
Summary: How much Urine can the Female Bladder Hold- assuming spincter muscle is 'paralyzed'?
My wife gave birth last Tuesday at a hospital in NYC. She was givin a low dose epidural (walking epidural) that allowed her to walk about and still have some sensation. She was able to urinate a bit throughout the labor (very slow trickle) and thought that it was sufficient to empty her bladder. She had an IV as well, went though about two bags before her delivery 12 hours later, and also was taking in some fluids orally. However by the time she was ready to push, the OB noticed that her bladder was very full (protruding a lot- a big bump on her stomach). She immediately gave her a catader, and was astonised by the volume that came out: 1.5 liters. She was extremely angry with the nurse staff for overlooking this- and made sure to report it.
My question: could she have sustained any damage to her bladder? She appears to have regained most of the mucle tone now (5 days later), but I'm concerned that the 1.5 liters could have damaged the muscle lining. She's only 100 lbs normally, and before her pregnancy could never really hold much urine (thought she had a small bladder). 1.5 liters is a tremendous amount I think, and would like to know if there could be any potential compliations. Becuase of the epidural, she lost most of her sensation, and if the spincter muscle (or whatever holds the bladder shut) was frozen shut, could the normal over-pressure dumping that typically occurs been over-ridden?
Thanks so much!
My wife gave birth last Tuesday at a hospital in NYC. She was givin a low dose epidural (walking epidural) that allowed her to walk about and still have some sensation. She was able to urinate a bit throughout the labor (very slow trickle) and thought that it was sufficient to empty her bladder. She had an IV as well, went though about two bags before her delivery 12 hours later, and also was taking in some fluids orally. However by the time she was ready to push, the OB noticed that her bladder was very full (protruding a lot- a big bump on her stomach). She immediately gave her a catader, and was astonised by the volume that came out: 1.5 liters. She was extremely angry with the nurse staff for overlooking this- and made sure to report it.
My question: could she have sustained any damage to her bladder? She appears to have regained most of the mucle tone now (5 days later), but I'm concerned that the 1.5 liters could have damaged the muscle lining. She's only 100 lbs normally, and before her pregnancy could never really hold much urine (thought she had a small bladder). 1.5 liters is a tremendous amount I think, and would like to know if there could be any potential compliations. Becuase of the epidural, she lost most of her sensation, and if the spincter muscle (or whatever holds the bladder shut) was frozen shut, could the normal over-pressure dumping that typically occurs been over-ridden?
Thanks so much!
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The volume you describe does sound to be large because you are accustomed to the volume you observe (which is usually less than 500 mL). During anesthesia, the bladder may be able to increase the amount, going beyond a litre is not really surprising. The concern for injury is indeed valid. The effect of overdistension would be a failure of the bladder to contract properly afterwards. This will be manifested as inadequate voiding, with a high volume of urine left in the bladder. This can be tested, so perhaps a consultation would be important to be certain. Stay positive.