Electro-Dry Needling For Postpartum Neurogenic Bladder With Persistent Urinary Retention: A Case Report

Background/Purpose: While physical therapy practice guidelines strongly support multiple interventions for bladder dysfunction, dry needling remains underexplored, especially in postpartum patients. This case report describes clinically meaningful improvements for persistent postpartum urinary retention and detrusor overdistention injury after incorporating sacral electro-dry needling with electrical stimulation as an adjunct to standard physical therapy. Case Description: A multiparous female, four weeks post-epidural-assisted vaginal delivery, presented to outpatient physical therapy with a medical diagnosis of neurogenic bladder, perinatal bladder overdistention, and recurrent urinary tract infections. Subjectively, she reported complete loss of sensation or ability to urinate, relying on intermittent catheterization or abdominal maneuvers. The plan of care included behavioral interventions, manual therapy, therapeutic exercise, and dry needling with needle manipulation and low-frequency electrical stimulation targeting sacral nerve roots. Outcomes: This patient returned to normal sensation and the ability to urinate without any compensatory strategies or additional urinary tract infections in 12 weeks. Single Assessment Numerical Evaluation increased from 15% to 80%; Pelvic Floor Distress Inventory-20 improved from 67.71 to 38.4, each exceeding two minimally clinically important differences. Discussion: This case demonstrates clinically meaningful improvements for postpartum neurogenic bladder with retention, incorporating electro-dry needling to the sacral nerve roots, a novel modality for this population. A limitation is the absence of post-void residual measurements, as the patient declined them.