Homeopathy never fails to amaze me! Even in the thirty first year of my practice, each new case is a delight. Below is one case of postpartum retention of urine. Pulsatilla, Staphysagria, Hydrastis and Cantharis were needed to complete the cure.
Mrs. A.S. 22 years came to the OPD on 03-11-2022.
The presenting complaint was retention of urine, with discomfort and mild pain around the lower abdomen, for the last 40 days. She had a Foley’s catheter in situ.
She had her first childbirth on 24-09-2022, 40 days ago. Full Term normal delivery of a healthy, active, female baby with no anomalies. After five-six hours of delivery when she failed to urinate and started to show some discomfort a temporary catheter was inserted and some urine produced.
This was followed by a waiting period of 10-12 hours with no urination again. Once she started to show the discomfort and heaviness due to this a foley’s was placed with the collection of urine till that time.
She was discharged from the hospital the next day with no other abnormalities except the catheter in situ and was advised to come back after four days to remove the same. After 4 days they removed the catheter in minor surgery and sent her home with the advice to drink enough water.
This was in the evening and they waited overnight with no voiding and came back. Another Foley was inserted and about 1200 ml urine was collected. Another attempt at removing the catheter after 10 days resulted in the same history. This time they waited for two full days after removing the catheter and when she couldn’t bear the pain any longer the Foley was inserted again.
This time around 2000ml of urine was collected and the catheter was left there for good. Between this she received three courses of antibiotics and some anti-anxiety drugs as well. This was besides the electrolytes and vitamins usually accompanying a postpartum prescription.
Her RFT was within normal limits. Other laboratory investigations were also good. She didn’t show any raised temperature and no other pain except mild pain at the vulva, which may have been due to the catheter in situ. The case was diagnosed as stricture of urethra and the discussion was going in the direction of a possible surgical intervention when they came to me for homeopathy.
Symptoms and Signs
While taking the history she was tearful and worried with much fear about voiding on her own. She almost believed her ordeal would never end. Apart from the discomfort and mild pain around the lower abdomen she was not having any particular symptoms.
Her appetite was good and thirst was present for plain water, with her drinking around 2 liters of daily. There was no headache, no pain in the abdomen or tympany. No history of nausea or vomiting. Bowel movements were also normal. She was found to be stable in her psyche other than the fear about voiding.
On examination her vitals were within normal limits; she was afebrile and there were no signs of oedema. Lover abdomen was soft to palpation but with mild tenderness. There was no tenderness in the renal angles and a general examination of the abdomen revealed nothing significant.
By nature, she was a typical Pulsatilla lady. fair, a little chubby, easily moved to tears and otherwise pleasant and cheerful.
Prescription and follow up
First prescription: On 03-11-2022 Pulsatilla 200 two doses were given to be taken at bed-time and the morning after with placebo to cover for one week. This was considering her overall mood, worry and weeping nature.
Advised to come after a week to try removal of catheter. On 07-11-2022. She was better in her mood and attitude. She was also ready for catheter removal. Foley was removed in the OPD at 5.30 pm which was uneventful.
Second prescription: Two doses of Apis mellifica 30. To be taken stat and the next morning. I’ve always used Apis for newborns when they failed to void in time. And here it is chosen only for the same reason. Also, there were no other symptoms to rely on!
Around 4pm the next day (on 08-11-2022) I got a call from the lady’s father about a successful voiding of sufficient quantities of urine!
She visited again on 11-11-2022. Voiding was normal, three four times daily. But she was having mild strangury- burning while urinating with an unfinished feeling. Urine is also high coloured and murky.
Prescription: Apis, one more dose given. Advised to come after a routine examination of urine. She was also advised to keep an input / output chart of drinking and urine.
Urine R/E on 12-11-2022 shows the following findings.
- Sp. gr. 1.025
- Colour. Turbid
iii. Pus cells (WBC)- 20-25/HPF
- Epi. Cells- 18-20/HPF
- RBC- 0-1/HPF
- Casts, Crystals- Nil
vii. Bacteria- Present- 1+
Water intake 2200 ml. Urine output 2030 ml.
Prescription:
Staphysagria 1M, one dose, at bedtime. (UTI from mechanical injury/trauma)
Hydrastis Q. Gtt 8 three times daily with a quarter glass of water. (as an antibacterial agent)
Follow up on 16- 11-2022
Urine clearer, strangury reduced but still present especially after voiding.
Prescription:
Staphysagria 1M one dose at bed time.
Cantharis 30. one drop in Aq dist. One spoonful to be taken from the mixture, four times daily, as the good old UTI remedy.
Advised to come with a repeat urine R/E.
Follow up on 25-11-2022.
She was symptom free. Urine is now clear, effortless and no strangury with clear urine. The I/O measurements the day before was 2200 ml/2050 ml.
Urine R/E
i. Sp. gr.- 1.020
ii. Pus cells- 3-6
iii. Epi. Cells- 4-6
iv. RBC- 1-3
v. Bacteria occasionally present.
Prescription:
1. Staphysagria 1M one dose at bed time.
2. Cantharis 30. TDS.
The case was closed for good. She did come after that a few more times but for deficient breast milk for her baby. But the urine complaints never returned.
