Acute urine retention in early pregnancy resulting from fibroid incarceration: proposition for management

Abstract

Objective: To define a therapeutic strategy adapted to acute urine retention resulting from uterine incarceration in early pregnancy.

Design: Case report and review of the literature.

Setting: University hospital.

Patient(s): Two cases of acute urine retention induced by severe fibroid incarceration in first trimester.

Intervention(s): After failure of preventive measures and maneuvers to reduce the incarceration, surgery was performed as a last resort.

Main outcome measure(s): Pregnancy and birth after surgery.

Result(s): One miscarriage 1 week after surgery and one normal pregnancy.

Conclusion(s): Acute urine retention constitutes an emergency, and rapid measures are essential to avoid extremely serious maternal morbidity. We propose a therapeutic strategy for managing this condition. Simple measures may be sufficient to prevent incarceration. Otherwise, bladder catheterization should be performed rapidly, and reduction measures attempted. If this approach fails, the incarcerated uterus must be treated as a last resort by surgery.