SENSORY STIMULATION PROGRAM FOR POSTPARTUM URINARY RETENTION PASIENS: A CASE REPORT

Abstract

Introduction: Retention Urine Postpartum (RUP) is the inability tourinate spontaneously after 6 hours post labor per vaginal or 24 hours post SC . This occurs because of the dyssynergy of the contraction mechanism which there is weakness of detrusor muscle and a decrease in the relaxation of the external urethral sphincter, increasing resistance to urine flow. Physiotherapy can be participate in providing stimulation of detrusor muscle and increasing relaxation of the external urethral sphincter. Case Presentation : Patient a woman , 27 years old, primigravidae, 7th day postpartum, catheter inserted , unable to urinate spontaneously , and still feel pain in the stitches , thus interfering with their functional activities. Management and Outcome : The patient is given a program of physiotherapy in the clinic and home program .Physiotherapy treatment is given every day for 11 days , namely sensory stimulation of tactile in the S2-S4 dermatome area which can stimulate pelvic and pudendal nerve. Tactile stimulation in the form of touch with light pressure on the sensory areas S2-S4. After treatment the started to urinate spontaneously after 4 days of treatment, even though the bladder had not completely emptied , disappearance of incisional pain in the perineum, and increased functional ability. Discussion : Giving sensory stimulation treatment in the area S2-S4 dermatome area will help stimulate the muscle contractions of detrusor muscle and the external urethral sphincter for relaxation so that the urine can come out spontaneously . In addition , sensory stimulation can reduce pain at the incision site in the perineum.