Clinical effect of moxibustion combined with acupoint application on early prevention of postpartum urinary retention in women with epidural analgesia and vaginal delivery

Background: Epidural analgesia increases postpartum urinary retention (PPUR) risk. This study assessed a combined acupuncture and acupoint application therapy for the prevention of PPUR. Objective: Through a retrospective cohort study, the effect of acupuncture combined with acupoint application therapy on preventing early PPUR in parturients who received epidural analgesia and delivered vaginally in a real clinical setting was evaluated. Method: In a retrospective cohort of 464 parturients receiving epidural analgesia, 240 received acupuncture (Shenque, Qihai) plus acupoint application (Shenque, Guanyuan, bilateral Shuidao) starting 2 hours postpartum for two days, while 224 received routine care. Outcomes included PPUR incidence (inability to void within 6 hours or residual volume ?150 mL), time to first void, residual volume, and catheterization rate. Results: The intervention group showed significantly lower PPUR incidence (11.67% vs. 25.89%, p < 0.01), earlier voiding (3.52±1.21h vs. 5.37±1.67h, p < 0.01), reduced residual volume (85.63±31.74mL vs. 128.95±45.21mL, p < 0.01), and lower catheterization (4.17% vs. 11.16%, p < 0.05). Multivariate analysis confirmed reduced PPUR risk (OR=0.393, 95% CI: 0.206 - 0.749). No serious adverse events occurred. Conclusion: Acupuncture combined with acupoint application may effectively reduce PPUR and improve postpartum bladder recovery with good safety.