Walking reduces the post-void residual volume in parturients with epidural analgesia for labor: a randomized-controlled study

Background: The post-void residual volume is higher among parturients who received epidural analgesia than those who received no or alternative analgesia.
Methods: This prospective, randomized, controlled, non-blinded study was performed in a tertiary referral center labor suite. The post-void residual volume was measured by a transabdominal ultrasound following a voiding attempt. Healthy parturients with low-dose epidural analgesia in active labor were randomized either to walk to the toilet or to use a bedpan for voiding. The primary outcome measure (post-void residual volume in labor) was compared between the study groups.
Results: The toilet group ( n =34) and the bedpan group ( n =28) demonstrated similar post-void residual volumes (212 ± 100 vs. 168 ± 93 ml, P =0.289). Twenty patients (59%) randomized to the toilet group were unable to walk and actually voided in a bedpan. A secondary analysis was performed analyzing the groups as treated. The post-void residual volume was significantly lower in the actual toilet group ( n =14, 63 ± 24 ml) vs. the bedpan group ( n =48, 229 ± 200 ml), P =0.0052. Thirteen (93%) women who walked to the toilet managed to void before the ultrasound measurement vs. 20/48 (42%) using the bedpan, P =0.001. Fewer women who managed to walk to the toilet required urinary bladder catheterization during the labor than women who used the bedpan (6/14, 43% vs. 36/48, 75%) P =0.028.
Conclusion: Women who were randomized to walk to the bathroom with epidural analgesia and were able to do so during labor had a significantly reduced post-void residual volume and a reduced requirement for urinary catheterization.