Effect of lumbar epidural analgesia on lower urinary tract function in the immediate postpartum period.

Urodynamic investigations including cystometry and electronic simultaneous urethro-cystometry were made in 27 primiparae between 2 and 5 days after delivery to assess possible effects of lumbar epidural analgesia on the function of the lower urinary tract. Three groups of patients were studied: 11 patients had vaginal delivery without epidural analgesia, 11 patients with similar obstetrical characteristics were delivered vaginally with epidural analgesia, and five others were delivered by caesarean section under epidural analgesia. The group of patients who were delivered vaginally under epidural analgesia had a significantly higher incidence (n = 4) of hypotonic bladders as determined by cystometry than the group without epidural analgesia (n = 0), (P less than 0.05). The maximum cystometric capacity was significantly greater (P less than 0.05) in the group who delivered vaginally with epidural analgesia than in the group without epidural analgesia, as well as the caesarean section group (with epidural analgesia), (P less than 0.01). Possible side effects of epidural analgesia implied by these results are discussed and a method for surveillance of urethrovesical function both during labour and after parturition is proposed.