Clinical Outcomes of Arabin Pessary Usage for Acute Urinary Retention and Uterine Prolapse during Pregnancy: A Case Report in Southeast Asia

Abstract

Acute urinary retention (AUR) is a rare obstetric emergency that requires prompt intervention before the development of irreversible maternal and foetal complications. To our knowledge, there is no published large-scale clinical trial on Arabin cerclage pessary usage in the combined issues of AUR and uterine prolapse in pregnancy. This case report describes the case of a 29-year-old gravida 2 para 1 woman with intrauterine pregnancy at 13 weeks of amenorrhea presented to the emergency department with suprapubic pain and inability to void. She has no past history of urogynaecological complaint and was subsequently catheterized with a Foley catheter. Within the next 12 hours, she presented with the same complaint. Gynaecological examination revealed grade 1 uterine prolapse with cystocele. A repeated catheterization for bladder drainage was done followed by insertion of an Arabin cerclage pessary due to the persistence of symptoms. Her symptoms resolved immediately without any complications and recurrence. She then delivered at term via lower segment caesarean section (LSCS). Therefore, Arabin cerclage pessary insertion could be used in pregnancy for woman with acute urinary retention and uterine prolapse beside its official indication.