Caring for a catheter after postpartum urinary retention

What does the evidence say about postpartum catheter care for urinary retention?

1. There are three main catheter types: indwelling, condom, and intermittent self-catheter. For an indwelling catheter, guidance calls for cleaning the area where it exits the body and the catheter itself with soap and water every day, drinking plenty of fluids, and washing your hands before and after handling the device. 1
2. For a suprapubic catheter, the opening in the belly and the tube should be cleaned with soap and water daily and covered with dry gauze. Warning signs needing prompt contact with a provider include fever or chills, urine that smells strong or looks thick or cloudy, and very little or no urine draining; a clogged, painful, or infected catheter needs prompt replacement. 1
3. Postpartum urinary retention is defined as an inability to void within 6 hours of delivery or catheter removal, or a post-void residual over 150 mL after urinating on your own. In a protocol comparing management approaches, clean intermittent self-catheterization was preferred over a continuously indwelling catheter, was well tolerated, and was not inferior for later urinary symptoms. 2
4. In that same review, the typical measure of retained urine had normalized by day 7 postpartum for most women, but a share of cases persisted longer: 8.2% at 1 year, 6.7% at 2 years, and 4.9% at 3 years, with rare but serious long-term bladder-muscle and nerve effects in a small number of cases. 2
5. In a hospital protocol study, 6.6% of women with postpartum urinary retention were discharged home with a catheter still in place because their retention had not resolved by discharge, and this group specifically required close outpatient follow-up. 3
6. A catheter drains urine from the bladder, which eases pain and protects the bladder and kidneys from damage. Catheters can be indwelling, left in place for a short or long time, or intermittent, inserted to drain the bladder and then removed, and general guidance notes that a health care professional teaches the technique for intermittent catheter use. 4

How this changes over time

• In the first days after birth, if you're sent home still unable to fully empty your bladder, a catheter, most often managed with clean intermittent self-catheterization taught by your care team, is a standard way to protect your bladder while nerve function recovers.
• By a few weeks postpartum, most women's bladder function has returned to normal, and any catheter use has typically ended, but if you're still using one or still having symptoms, that's a reason for follow-up rather than assuming it will resolve on its own.
• Later in the postpartum period, a small share of women have retention symptoms that persist for a year or more. Ongoing follow-up with your care team matters even months out, since the research behind this brief found measurable, if uncommon, longer-term effects.

Catheter care checklist