Postpartum retention of urine has been extensively documented in various medical texts throughout history. Zhubing Yuanhou Lun specifically established the conditions of "postpartum retention of urine" and "postpartum constipation and urinary retention"; Zhangshi Yitong、Nyuke Jinglun、and "Shen's Nyuke Jiyao Commentary" also discussed the diagnosis and treatment of "postpartum retention of urine"; Zhengzhi Zhunsheng and Jiyin Gangmu combined the discussion of "postpartum constipation and urinary retention."

bubble_chart Pattern Analysis

1. Qi Deficiency︰Postpartum retention of urine, lower abdominal distension and fullness with urgency, mental fatigue, weak speech, thin white tongue coating, normal or weak pulse. Mostly caused by weak constitution, excessive blood loss during childbirth leading to qi depletion along with blood, resulting in spleen and lung qi deficiency, which fails to regulate water pathways and transport it downward to the bladder. Common symptoms include lower abdominal distension and fullness, accompanied by weak speech, shortness of breath, mental fatigue and lack of strength, pale complexion, and other associated signs. The treatment principle is to tonify qi and strengthen the spleen, ventilate the lungs to promote water movement. Prescriptions such as Qi-Tonifying and Bladder-Unblocking Decoction with Platycodon Root and Bitter Apricot Seed, or Middle-Tonifying Qi-Replenishing Decoction with Cassia Bark and Ricepaperplant Pith are recommended.
2. Kidney Deficiency︰postpartum retention of urine, lower abdominal distension and fullness, soreness and distension in the waist, restlessness in sitting or lying, dull complexion, white or pale tongue coating, deep and slow pulse. It is caused by kidney qi injury during childbirth or congenital kidney qi deficiency, leading to unfavorable bladder qi transformation. The key points of pattern identification are: frequent lower abdominal distension, urgency, and fullness, accompanied by soreness and distension in the waist, dull complexion, deep and slow pulse, etc. For treatment, it is advisable to warm yang and tonify the kidney, warm the bladder and promote urination. The prescription can be Supplemented Kidney Qi Pill, or Kidney Qi Pill with motherwort herb and Chinese Angelica.
3. Qi Stagnation︰Postpartum retention of urine, lower abdominal distension and fullness with pain, depressed mood, or chest and hypochondriac fullness, thin white tongue coating, wiry and thin pulse. It is an excess pattern. Mostly caused by mental stimulation, emotional stagnation, liver qi depression, obstruction of qi movement, imbalance of the ascending and descending of clear and turbid, and dysfunction of bladder qi transformation. The clinical features include: a history of mental stimulation, manifestations such as depression, dysphoria and irritability, distension in the hypochondriac region, lower abdominal distension and fullness with pain, thin white tongue coating, wiry pulse, etc. The treatment should focus on soothing the liver and regulating qi, promoting urination. The prescription used is Akebia Stem Powder with Lindera and motherwort herb. For those with weak constitution, use Peripatetic Powder minus fried ginger and Mentha, adding Lindera, Submature Bitter Orange, Plantain Seed, and motherwort herb.

bubble_chart Documentation

1. Nyuke Jinglun．Postpartum Syndrome Collection says: "Postpartum retention of urine, abdominal distension and fullness like a drum, confusion and unconsciousness, due to the accumulation of cold qi before childbirth, leading to the movement of the bladder during childbirth. Use salt to fill the navel level, crush Fistular Onion Stalk to the thickness of a finger, place it on the salt, and moxibustion on the cake. When heat is felt entering the abdomen, urination will be immediately facilitated, which is miraculously effective."
2. 《Gu Yingtuo's Gynecology Collection．Postpartum Category》"Postpartum retention of urine is mostly caused by exposure to cold before childbirth, leading to the bladder's movement being obstructed after childbirth, resulting in difficulty in urination, abdominal distension and fullness like a drum, confusion and unconsciousness. The treatment method, if due to qi deficiency and inability to transform, should be treated with modified Four Gentlemen Decoction. If lochia is not smooth, with difficulty in urination and diarrhea, Five Ingredients with Poria Powder with double Cassia Bark and Peach Kernel should be used. If both urine and stool are obstructed and lochia does not flow, lochia should be cleared first, using Si Wu Tang with added Curcuma and Hawthorn Fruit. If due to qi blockage, use fried salt with two li of musk, fill the navel, externally use a bundle of more than ten Fistular Onion Stalks, cut to half a finger's thickness, place on the salt on the navel, and apply moxibustion. When heat is felt entering the abdomen and becomes unbearable, stop, and urination will be facilitated. However, this method is contraindicated for those with qi deficiency and source depletion, and heat accumulation in the bladder."