Effect of Voiding Position (Standing in the Shower vs. Sitting) on Post- Void Residual Urine Volume (PVR) After Removal of Urinary Catheter in Women Following Vaginal Delivery With Epidural Analgesia: A Double- Blind Randomized Controlled Trial

Postpartum urinary retention is a common complication after childbirth, with a higher risk for women who undergo vaginal delivery with epidural analgesia. This study aims to determine whether performing the first void after the removal of an indwelling urinary catheter in a standing position in the shower, compared to sitting on a toilet, helps reduce postpartum urinary retention. The study will include 100 women who had a vaginal delivery with epidural analgesia. Participants will be randomly assigned to either void while standing in the shower (Group A) or sitting on the toilet (Group B). Immediately after this first spontaneous void, the post-void residual urine volume (PVR) will be measured using an ultrasound bladder scan. The study seeks to find out if the standing position facilitates more complete bladder emptying, reduces the need for recatheterization, and decreases perineal pain compared to the sitting position.

Inclusion Criteria: * Inclusion Criteria:Adult women (≥18 years old) Singleton pregnancy at ≥37+0 weeks Vaginal delivery (spontaneous or instrumental) Epidural analgesia during labor Indwelling urinary catheter placed during labor or immediately postpartum, with planned removal according to standard clinical protocol Ability to stand (with or without minimal assistance) and to void in the standing or sitting position as allocated Ability and willingness to provide informed consent Exclusion Criteria:Previous known voiding dysfunction or neurogenic bladder Known neurological disease affecting bladder function Major urologic or pelvic reconstructive surgery Obstetric anal sphincter injury grade 3-4 when mobility restrictions or special perineal care preclude standing shower voiding Hemodynamic instability or severe obstetric complications (e.g., severe postpartum hemorrhage, eclampsia) precluding mobilization Active urinary tract infection at the time of catheter removal (clinical signs/symptoms or positive urine culture, as per local protocol) Inability or unwillingness to void in the allocated position Refusal or withdrawal of consent