info@auctorespublishing.com
+1-(302)-520-2644
+1-(302)-520-2644

A Brief Overview About Postpartum Urinary Retention

  1. Home
  2. Journals
  3. New Medical Innovations and Research
  4. Current Issues
Submit Guidelines

Review Article | DOI: https://doi.org/10.31579/2767-7370/111

A Brief Overview About Postpartum Urinary Retention

  • Asma Marwan Al-Rawi 1*
  • Laila Yahya Al-Hubaishi 2

1 Obgyn PGY-1 at Dubai Health, United Arab Emirates (UAE).

2 Consultant Obgyn at Dubai Health, United Arab Emirates (UAE). 

*Corresponding Author: Asma Marwan Al-Rawi, Obgyn PGY-1 at Dubai Health, United Arab Emirates.

Citation: Asma Marwan Al-Rawi and Laila Yahya Al-Hubaishi, (2024), A Brief Overview About Postpartum Urinary Retention, J New Medical Innovations and Research, 5(6); DOI:10.31579/2767-7370/111

Copyright: © 2024, Asma Marwan Al-Rawi. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received: 01 July 2024 | Accepted: 10 July 2024 | Published: 22 July 2024

Keywords: cesarean deliveries; postpartum; urinary retention; vaginal deliveries

Abstract

Background: Postpartum urinary retention (PUR) or puerperal urinary retention is quite a common obstetric condition affecting postpartum women. Despite its significance, ubiquity, and morbidity, it remains an under-discussed and poorly understood topic. 

Objective: This literature review is aimed to examine the latest research and findings in the field, with a focus on three key areas: the incidence and risk factors of PUR, the comparison of PUR in vaginal versus cesarean deliveries, and the management and prevention strategies. Since we believe it needs to receive more attention and awareness.

Conclusion: In conclusion, PUR is a complex condition with varying incidence and contributing factors. Understanding its pathophysiology, risk factors, and effective management strategies is essential for better outcomes in postpartum care.

Introduction

Urinary retention (UR) is the inability to empty the bladder normally. Postpartum voiding dysfunction is defined as failure to pass urine spontaneously within six hours of vaginal delivery or catheter removal [45]. Another common clinical definition of urinary retention is significant post-void residual bladder volume (PVRBV), where PVRBV is defined as the volume of fluid remaining in the bladder immediately following the completion of micturition [8, 30, 69]

The presence of PVRBV implies an imbalance between the forces of urine expulsion and the outflow resistance or a failure or decrease in detrusor contractility. Accordingly, a significant PVRBV represents an abnormality of bladder function and could be used as the definition of PUR. Postpartum urinary retention (PUR) is a common condition in obstetric units. It is also known as puerperal urinary retention or insidious urinary retention after vaginal delivery [61]. If postpartum voiding dysfunction is not diagnosed promptly, it can lead to bladder over-distension and activity, and prolonged voiding dysfunction, with sequelae such as incontinence and recurrent urinary tract infections (UTIs), [16]. 

The definition of PUR varies among studies. Yip et al. (1997) divided PUR into overt and covert urinary retention, with overt PUR defined as an inability to urinate autonomically 6 h after vaginal delivery or the need for re-catheterization 6 h after catheter removal following cesarean section. Carley et al. (2002) defined PUR as an inability to undergo spontaneous micturition within 12 h after vaginal delivery. However, other reports defined PUR as a symptom requiring at least one catheterization within the first 24 h postpartum [10,50].

Bladder symptoms that should raise clinical suspicion of voiding dysfunction include urinary frequency, voiding small amounts, slow or intermittent stream, bladder pain or discomfort, straining to void, reduced sensation to void, incomplete emptying of the bladder and urinary incontinence [15, 17]. PUR can be silent, and some women may be unaware of the large volume of urine in the bladder or that they are unable to void to completion. This may occur because of reduced bladder sensation and contractility due to injury or trauma to the nerves supplying the bladder [43].

The reported prevalence of PUR varies widely ranging from 1.7%–17.9%. In a recent study, the overall prevalence of PUR was 12.9 % [64]. There is increased risk of voiding dysfunctions leading to PUR in the postpartum period due to the physiological changes and traumatic events occurring during pregnancy and childbirth [47]. The reported incidence of postpartum voiding dysfunction varies considerably due to differences in the definition, methods of diagnosis, and mode of delivery. Overt UR incidences range from 0.45%, 1.7% to 17.9%, and from 0.05% to 37% have been reported [38]. 

The incidence of UR following cesarean section varies between 3.38% and 11.5% [60]. However, if post-void residuals are not checked and recorded, it may not be possible to identify these women. As a result, the actual incidence may be higher than reported, and as many as 5% of these women may have significant and long-term bladder dysfunction [32].

Classification 

Two types of urinary retention can affect a woman in the postpartum period [59]. PUR is classified as overt, which is defined as the inability to void spontaneously within 6 h of either vaginal delivery or catheter removal after delivery [36]. Overt or symptomatic urinary retention is easily detectable, with clear clinical appearance, and therefore is adequately treated (Figure 1), [19]. 

A diagram of a flowchart Description automatically generated

Figure 1: Postpartum overt urinary retention

 

The covert form can be identified by elevated post-voiding residual volume (PVRV) measurements, using ultrasound scanning or catheterization after urination [18]. It occurs when a woman passes small amounts of urine and has an elevated post-void residual urine volume greater than 150ml with no symptoms of UR (Figure 2), [21].

Figure 2: Postpartum covert urinary retention.

Pathophysiology 

The pathophysiology of PUR is not well understood; however, several hypotheses exist regarding physiological, neurologic, and mechanical factors related to pregnancy and the immediate postpartum period [25]. The bladder is a hormone-responsive organ. Pregnancy-related changes, including increased progesterone, reduced bladder muscle tone, increased capacity, increased urethral length, and increased maximal urethral closure pressure may contribute to PUR development [40].

During pregnancy and immediately postpartum, increased progesterone levels inhibit smooth muscle tone and may contribute to detrusor inhibition [27]. Impaired detrusor contractility combined with a lack of urethral relaxation may explain a component of the urinary retention mechanism [9]. One study demonstrated that pregnancy induced a 50 percent decrease in bladder muscarinic receptor density, which correlated with a 50 percent decrease in the contractile response to bethanechol [43]. 

Another PUR mechanism involves pelvic, hypogastric, and pudendal nerve injury during delivery [2]. Neurologic consequences vary depending on the complex interactions of partial or complete injuries with the parasympathetic, sympathetic, and somatic nervous systems [67]. Sympathetic nerve injuries result in decreased bladder compliance and high storage pressures because of beta-adrenergic denervation, whereas parasympathetic nerve injuries produce a hypo contractile bladder with decreased sensation. These nerve injuries, which are typically transient in nature and resolve within three months postpartum, have been demonstrated through electrophysiological research [43]. 

During a vaginal delivery, ischemic nerve injury can occur from a prolonged second stage of labor, and direct partial or complete nerve transection can result from either spontaneous or operative birth trauma [55]. Denervation can occur during cesarean delivery in cases complicated by substantial hemorrhage or in those requiring a cesarean hysterectomy [55]. Regional analgesia acts as a potential iatrogenic contributor to PUR, directly affecting bladder sensitivity and contractility. It also temporarily disrupts afferent input arising from bladder stretch receptors, which may be damaged by overdistention intrapartum [46]. 

Periurethral and vulvar edema can lead to mechanical urethral obstruction and impaired voiding [9]. Pain associated with obstetrical lacerations may preclude relaxation of pelvic floor muscles, which is the first step in initiating a spontaneous void. Furthermore, patient discomfort with voiding in unfamiliar locations and lack of privacy are possible contributors to PUR [33].

Risk Factors 

Independent risk factors for PUR vary and are often limited by confounding factors. Frequently proposed risk factors include epidural anesthesia, operative vaginal delivery, prolonged labor duration, episiotomy, newborn macrosomia, nulliparity, and obstetric anal sphincter injury [5]. A systematic review of PUR risk factors found that operative vaginal delivery was the only clinical factor with a consistently strong association with PUR [39]. 

Operative vaginal delivery may result in direct pelvic floor and bladder trauma, edema that results in mechanical outlet obstruction, or impaired reflex and voluntary relaxation of the sphincter urethrae, periurethral muscles, and pelvic floor [4]. It is unclear whether operative vaginal delivery is an individual risk factor, or if it is confounded by other concurrent risk factors such as epidural, episiotomy, prolonged labor, and parity [43]. 

In a multivariate analysis, labor duration >700 minutes was the only factor that predicted PUR. Ultimately, multiple risk factors likely act synergistically to impair normal postpartum micturition processes > 700 minutes was the only factor that predicted PUR. Ultimately, multiple risk factors likely act synergistically to impair normal postpartum micturition processes [44]. 

The PUR was ascribed to maternal anxiety, nervousness, genital injuries, such as vulval and vaginal lacerations, and derangement of the neuromuscular innervation of the bladder. Some of these factors have been proven using urodynamics, electrophysiology, and histochemistry of the detrusor muscle. [30] 

Diagnosis 

The evaluation of the patient with suspected urinary retention should begin with a detailed history to elucidate the precise etiology, as summarized in Table 1 [23]. The initial evaluation should also include a thorough medication history, including the use of over-the-counter medications and herbal supplements [58, 63].

Potential etiologyHistoryPhysical examination
Cystocele; rectocele; uterine prolapsePelvic pressure; palpation of a pelvic organ from the vaginaProlapse of bladder, rectum, or uterus
Uterine fibroid, pelvic mass, or malignancyPelvic or lower abdominal pain, dysmenorrhea, bloatingPalpable uterus, ovaries, or adnexa
VulvovaginitisVaginal discharge, vaginal itching, dysuriaInflamed or erythematous vulva or vagina, vaginal discharge

Table 1: History and physical examination findings that suggest etiologies of urinary retention [54].

Physical examination should include a complete abdominal assessment, including palpation and percussion of the bladder and abdominal/ pelvic organs; evaluation for flank tenderness; a complete pelvic examination in women; and a neurologic evaluation to assess strength, sensation, muscle tone, and reflexes relative to lower thoracic, lumbar, and sacral spinal levels [53, 54]

Testing should include a postvoid residual (PVR) urine evaluation, which is a simple, noninvasive, and cost-effective volume measurement of urine within the bladder that can be performed with ultrasonography [12]. The bladder can be percussed when it contains 150 mL of urine and is palpated with greater than 200 mL [65]. No evidence supports a specific PVR threshold for patients with chronic urinary retention; however, the American Urological Association has recommended using a value greater than 300 mL that has persisted for at least six months and has been documented on two separate occasions [1,57].

Postpartum evaluation of postpartum urinary retention 

Patients should spontaneously void within 6 hours after the last bladder drainage or catheter removal [44]: 

  • All patients: the first 2 voids should be measured, and an ultrasound should be performed to assess PVR if the patient’s initial attempts are unsuccessful, urine output is inadequate (<30>< mL/h), or if clinical signs or symptoms of PUR are present [66]. The patient should enter the PUR management algorithm if the bladder volume is ≥ 150 mL on the scan [37]. 
  • Assessment of bladder urine volume: this can be performed with a bladder scan to determine the urine volume, followed by catheter placement for more accurate measurement [41].
  • Active voiding trial (AVT): perform after 24 hours of indwelling urethral catheter. We recommend an AVT because it provides a controlled, efficient approach to evaluate the adequacy of bladder emptying and reduces urinary tract injury (UTI) risk [35]. Drain the bladder completely into the urine collection bag. Disconnect the catheter from the urine collection bag and back-fill the bladder with 300 mL of sterile water or saline. If the patient has no sensation to void, volumes up to 500 mL can be instilled. For patients with increased bladder sensation or decreased capacity, volumes as low as 200 mL can be instilled [22]. The patient must void at least two-thirds of the instilled volume within 30 minutes of instillation [20].

If PVR evaluation cannot be obtained or is thought to be inaccurate, patients with suspected urinary retention should be catheterized for bladder decompression and accurate measurement of stored urine [54].

Treatment 

Intermittent self-catheterization 

When PUR is persistent, management with intermittent self-catheterization (ISC) or indwelling urethral catheter is indicated regardless of whether the patient is symptomatic [23]. This prevents further bladder injury by keeping the bladder decompressed while awaiting the return of normal bladder function [7]. The advantages of indwelling urethral catheter placement include complete bladder rest and lack of need for ISC teaching [6]. Disadvantages include increased infection risk, need for in-office voiding trials, and inability to monitor ongoing progress [44]. 

High fluid intake in mothers expressing milk coupled with postpartum diuresis and diminished bladder sensation may make it challenging to perform frequent self-catheterization and avoid overdistention [43]. To balance these challenges, we strongly recommend using an indwelling catheter for the first 5 to 7 days, followed by ISC if needed [42]. Whether to manage persistent PUR with ISC or with an indwelling urethral catheter is not well-studied, and no guidelines exist [24, 28]. 

Female urology referral

In some centers, urogynecology or female urology referral is placed when PUR is diagnosed or persists [34].  When these services are available, it is recommended that referral at the time of hospital discharge for women with unresolved PUR. These providers have AVT supplies, staff with expertise in teaching ISC, and the ability to perform additional testing. However, it is important to note that urodynamic testing and imaging studies are not routinely indicated for women with PUR and should be reserved only for women with atypical symptoms, a concerning history, or considerably prolonged PUR [37].

Acupuncture

Acupuncture has been studied for PUR treatment at the time of diagnosis in the immediate postpartum period. In a randomized trial of 55 women with PUR, 92% in the acupuncture group achieved spontaneous micturition within 1 hour following treatment [29]. 

Bethanechol chloride

Bethanechol chloride is a U.S. Food and Drug Administration-approved cholinergic medication for the treatment of acute postpartum nonobstructive urinary retention.38 Dosing begins at 5 to 10 mg, 3 times per day with dose escalation as needed. Side effects of bethanechol include flushing, tachycardia, diarrhea, vomiting, and urinary urgency [43]. 

Tamsulosin

Tamsulosin, an alpha-adrenergic receptor antagonist acting at the level of the bladder, neck, and urethra, is efficacious in preventing postoperative urinary retention in an Ur gynecological population [13]. 

Postpartum prevention and management

Prevention of PUR requires avoiding bladder overdistention during labor [31]. The American College of Obstetricians and Gynecologists recommended assessing all women for bladder emptying in the first 24 hours postdelivery to avoid PUR [25]. Normal urine output is defined as 0.5 to 1.5 mL/kg/h.27 We suggest inadequate urinary output be defined as 150 mL [26]. Either modality can be used to screen for an elevated PVR; however, precise bladder volumes should not be expected. For volumes ≥150 mL, a catheter should be used to assess the PVR accurately [14]. 

Figure 3 illustrates the postpartum bladder management protocol, developed by group consensus with the incorporation of a variety of protocols currently used nationally and internationally [62]. The algorithm begins with identifying overt or covert PUR, followed by step-by-step guidance for management and discharge disposition [43].

A flowchart of a patient Description automatically generated

Figure 3: Postpartum bladder management protocol [43]

Postpartum voiding dysfunction following vaginal versus cesarean delivery

Labor is associated with pelvic floor disorders both voiding dysfunction and fecal incontinence [48]. Whether this is caused by pregnancy or delivery itself is unknown. The reported incidence of postpartum voiding dysfunction ranges between 1.7% and 43% following vaginal delivery [51]. Prolonged second stage, instrumental delivery, and high birth weight increase this risk [49]. 

Voiding assessment is a crucial part of postpartum care. This involves the determination of risk factors and early promotion of first urination. While most studies on postpartum voiding dysfunction were related to vaginal delivery, little is known about the effect of the mode of delivery (vaginal versus CD) on voiding dysfunction [69]. One study that compared postpartum PVRV in nulliparous following vaginal or CD, found that women after vaginal delivery had higher rates of PVRV compared to CD [3].

In elective CD, the operation is performed before uterine contractions and the fetal head is relatively high in the pelvis. Therefore, postpartum PVRV may be higher in the vaginal delivery group compared to CD. A recent study suggests that delivery adversely affects voiding function, and that vaginal delivery is associated with more severe bladder dysfunction compared to elective CD [52].

Conclusion

In conclusion, PUR is a complex condition with varying incidence and contributing factors. Understanding its pathophysiology, risk factors, and effective management strategies is essential for better outcomes in postpartum care.

References

  1. Abello A, DeWolf WC, Das AK. (2019). Expectant long‐term follow‐up of patients with chronic urinary retention. Neurourology and Urodynamics. 38(1):305-309.
    View at Publisher | View at Google Scholar
  2. Alas AN, Hurtado EA. (2015). Is postpartum urinary retention a neurogenic phenomenon? Current Bladder Dysfunction Reports. 10(4):318-324.
    View at Publisher | View at Google Scholar
  3. Al‐Mandeel H, al‐badr A, al‐shaikh G. (2014). Incidence of early postpartum voiding dysfunction in primiparae: comparison between vaginal delivery and cesarean section. LUTS: Lower Urinary Tract Symptoms. 6(2):103-106.
    View at Publisher | View at Google Scholar
  4. Augustin G. (2023). Urinary Tract Obstruction or Rupture. InAcute Abdomen During Pregnancy Cham: Springer International Publishing. pp. 963-995.
    View at Publisher | View at Google Scholar
  5. Bączek G, Rychlewicz S, Sys D, Rzońca P, Teliga-Czajkowska J. (2022). Episiotomy for medical indications during vaginal birth-retrospective analysis of risk factors determining the performance of this procedure. Journal of Clinical Medicine. 11(15):4334.
    View at Publisher | View at Google Scholar
  6. Balhi S, Arfaoui RB. (2021). Barriers affecting patient adherence to intermittent self-catheterisation. British Journal of Community Nursing. 26(9):444-451.
    View at Publisher | View at Google Scholar
  7. Beal MW. (2018). Interventional management of urethral obstructions. Veterinary Clinics: Small Animal Practice. 48(5):863-874.
    View at Publisher | View at Google Scholar
  8. Beyazıt A, Hakverdi AU, Gözükara KH. (2023). The Effect of Pregnancy on Urinary Symptoms. Cureus 15(8).
    View at Publisher | View at Google Scholar
  9. Biurrun GP, Gonzalez-Díaz E, Fernández CF, Corona AF. (2020). Post-partum urinary retention and related risk factors. Urology. 143:97-102.
    View at Publisher | View at Google Scholar
  10. Cao D, Rao L, Yuan J, Zhang D, Lu B. (2022). Prevalence and risk factors of overt postpartum urinary retention among primiparous women after vaginal delivery: a case-control study. BMC Pregnancy and Childbirth. 22(1):26.
    View at Publisher | View at Google Scholar
  11. Carley ME, Carley JM, Vasdev G, Lesnick TG, Webb MJ, et. al., (2002). Factors that are associated with clinically overt postpartum urinary retention after vaginal delivery. American journal of obstetrics and gynecology. 187(2):430-433.
    View at Publisher | View at Google Scholar
  12. Ceyhan E, Asutay MK. (2021). Standardization for reliable uroflowmetry testing in adults. LUTS: Lower Urinary Tract Symptoms. 13(1):45-50.
    View at Publisher | View at Google Scholar
  13. Chapman GC, Sheyn D, Petrikovets A, Mahajan ST, El-Nashar S, et. al., (2020). Tamsulosin to prevent postoperative urinary retention after female pelvic reconstructive surgery. Urogynecology. 26(11):682-687.
    View at Publisher | View at Google Scholar
  14. Cho KJ, Kim JC. (2020). Management of urinary incontinence with underactive bladder: a review. International neurourology journal. 24(2):111.
    View at Publisher | View at Google Scholar
  15. Clothier JC, Wright AJ. (2018). Dysfunctional voiding: the importance of non-invasive urodynamics in diagnosis and treatment. Pediatric Nephrology. 33:381-394.
    View at Publisher | View at Google Scholar
  16. Cox S, Reid F. (2018). Urogynaecological complications in pregnancy: an overview. Obstetrics, Gynaecology & Reproductive Medicine. 28(3):78-82.
    View at Publisher | View at Google Scholar
  17. D'Ancona C, Haylen B, Oelke M, Abranches‐Monteiro L, Arnold E, et. al., (2019). The International Continence Society (ICS) report on the terminology for adult male lower urinary tract and pelvic floor symptoms and dysfunction. Neurourology and urodynamics. 38(2):433-77.
    View at Publisher | View at Google Scholar
  18. Dolezal P, Ostatnikova M, Balazovjechova B, Psenkova P, Zahumensky J. (2022). Covert postpartum urinary retention: causes and consequences (PAREZ study). International urogynecology journal. 33(8):2307-2014.
    View at Publisher | View at Google Scholar
  19. Dolezal P, Zahumensky J, Otapkova P, Papcun P, Krizko J. Covert postpartum urinary retention. Clinical study. 2019 673:675.
    View at Publisher | View at Google Scholar
  20. Dolgun NZ, Jones K, Harmanli O. (2021). Voided volume for postoperative voiding assessment following prolapse and urinary incontinence surgery. International urogynecology journal. 32:587-591.
    View at Publisher | View at Google Scholar
  21. Doumouchtsis SK, de Tayrac R, Lee J, Daly O, Melendez-Munoz J, et. al., (2023). An International Continence Society (ICS)/International Urogynecological Association (IUGA) joint report on the terminology for the assessment and management of obstetric pelvic floor disorders. International urogynecology journal. 34(1):1-42.
    View at Publisher | View at Google Scholar
  22. Ganguly A, Tyagi S, Chermansky C, Kanai A, Beckel J, et. al., (2023). Treating Lower Urinary Tract Symptoms in Older Adults: Intravesical Options. Drugs & aging. 40(3):241-261.
    View at Publisher | View at Google Scholar
  23. Gomelsky A, Steckenrider H, Dmochowski RR. (2022). Urgency and urgency incontinence following stress urinary incontinence surgery: A review of evaluation and management. Indian Journal of Urology. 38(4):268-275.
    View at Publisher | View at Google Scholar
  24. Gupta A, Pampapati V, Khare C, Murugesan R, Nayak D, et. al., (2021). Postpartum urinary retention in women undergoing instrumental delivery: A cross‐sectional analytical study. Acta Obstetricia et Gynecologica Scandinavica. 100(1):41-47.
    View at Publisher | View at Google Scholar
  25. Hickman LC, Yao M, Propst K. (2022). Protracted postpartum urinary retention: incidence, risk factors, and natural history of a rare postpartum urinary retention subtype. Urogynecology. 28(12):887-893.
    View at Publisher | View at Google Scholar
  26. Jensen JT, Klarskov N, Lauenborg J. (2020). Validity of bladder volume measurement by ultrasound in women postpartum. International Urogynecology Journal. 31:643-649.
    View at Publisher | View at Google Scholar
  27. Kashif U, Riaz N, Ramasubramanian SP, Iles D. (2021). Urogynaecological complications in pregnancy. Obstetrics, Gynaecology & Reproductive Medicine. 31(2):42-47.
    View at Publisher | View at Google Scholar
  28. Lamblin G, Chene G, Aeberli C, Soare R, Moret S, et. al., (2019). Identification of risk factors for postpartum urinary retention following vaginal deliveries: a retrospective case-control study. European Journal of Obstetrics & Gynecology and Reproductive Biology. 243:7-11.
    View at Publisher | View at Google Scholar
  29. Lauterbach R, Sokolovski CF, Rozenberg J, Weissman A. (2018). Acupuncture for the treatment of post-partum urinary retention. European Journal of Obstetrics & Gynecology and Reproductive Biology. 223:35-38.
    View at Publisher | View at Google Scholar
  30. Lawal OO, Morhason‐Bello IO, Atalabi OM, Ojengbede OA. (2022). Incidence of postpartum urinary retention in a tertiary hospital in Ibadan, Nigeria. International Journal of Gynecology & Obstetrics. 156(1):42-47.
    View at Publisher | View at Google Scholar
  31. Li S, Zhang X, Liu Y, Wang Y, Zheng X. (2023). The Occurrence and Factors Associated with Overt Urinary Retention Among Postpartum Women After Vaginal Delivery with Labor Epidural Analgesia. International Journal of General Medicine. Dec 31:5333-5341.
    View at Publisher | View at Google Scholar
  32. Lukacz ES, Santiago-Lastra Y, Albo ME, Brubaker L. (2017). Urinary incontinence in women: a review. Jama. 318(16):1592-1604.
    View at Publisher | View at Google Scholar
  33. Meister MR, Sutcliffe S, Badu A, Ghetti C, Lowder JL. (2019). Pelvic floor myofascial pain severity and pelvic floor disorder symptom bother: is there a correlation? American journal of obstetrics and gynecology. 221(3):235-e1.
    View at Publisher | View at Google Scholar
  34. Mevorach Zussman N, Gonen N, Kovo M, Miremberg H, Bar J, et. al., (2020). Protracted postpartum urinary retention—a long-term problem or a transient condition? International Urogynecology Journal. 31:513-519.
    View at Publisher | View at Google Scholar
  35. Mills JT, Rapp DE, Shaw NM, Hougen HY, Agard HE, et. al., (2020). Effect of active versus passive void trials on time to patient discharge, urinary tract infection, and urinary retention: a randomized clinical trial. World Journal of Urology. 38:2247-2252.
    View at Publisher | View at Google Scholar
  36. Miyamoto K, Komatsu H, Nagata H, Nagira K, Motomura E, et. al., (2024). Prolonged second stage of labor in delivery using epidural analgesia is a risk factor for postpartum urinary retention. Journal of Obstetrics and Gynaecology Research. Mar;50(3):424-429.
    View at Publisher | View at Google Scholar
  37. Mohr S, Raio L, Gobrecht-Keller U, Imboden S, Mueller MD, et. al., (2022). Postpartum urinary retention: what are the sequelae? A long-term study and review of the literature. International urogynecology journal. 33(6):1601-1608.
    View at Publisher | View at Google Scholar
  38. Moossdorff-Steinhauser HF, Berghmans BC, Spaanderman ME, Bols EM. (2021). Prevalence, incidence and bothersomeness of urinary incontinence between 6 weeks and 1 year post-partum: a systematic review and meta-analysis. International Urogynecology Journal. 32(7):1675-1693.
    View at Publisher | View at Google Scholar
  39. Murphy DJ, Strachan BK, Bahl R, Royal College of Obstetricians and Gynaecologists. (2020). Assisted vaginal birth: green‐top guideline no. 26. BJOG: An International Journal of Obstetrics & Gynaecology. 127(9): e70-112.
    View at Publisher | View at Google Scholar
  40. Murray I, Hendley J. (2020). Change and adaptation in pregnancy. Myles' Textbook for Midwives E-Book: Myles' Textbook for Midwives E-Book.:197.
    View at Publisher | View at Google Scholar
  41. Nasrabadi MZ, Tabibi H, Salmani M, Torkashvand M, Zarepour E. (2021). A comprehensive survey on non-invasive wearable bladder volume monitoring systems. Medical & Biological Engineering & Computing. 59:1373-1402.
    View at Publisher | View at Google Scholar
  42. Newman DK, New PW, Heriseanu R, Petronis S, Håkansson J, Håkansson MÅ, et. al., (2020). Intermittent catheterization with single-or multiple-reuse catheters: clinical study on safety and impact on quality of life. International urology and nephrology. 52(8):1443-1451.
    View at Publisher | View at Google Scholar
  43. Nutaitis AC, Meckes NA, Madsen AM, Toal CT, Menhaji K, et. al., (2023). Postpartum urinary retention: an expert review. American journal of obstetrics and gynecology. 228(1):14-21.
    View at Publisher | View at Google Scholar
  44. O'Kane M, Rantell A. (2023). Intrapartum and postpartum bladder management: the poor relation of modern obstetrics. Obstetrics, Gynaecology & Reproductive Medicine. 33(7): 190-196.
    View at Publisher | View at Google Scholar
  45. Pan WL, Chen LL, Wang CH, Mu PF, Tsay SF, et. al., (2023). Enhancing bladder management for intrapartum/postpartum women at a maternity hospital in Taiwan: a best practice implementation project. JBI evidence implementation. 21(3):197-207.
    View at Publisher | View at Google Scholar
  46. Panicker JN, Anding R, Arlandis S, Blok B, Dorrepaal C, et. al., (2018). Do we understand voiding dysfunction in women? Current understanding and future perspectives: ICI‐RS 2017. Neurourology and Urodynamics. 37(S4): S75-85.
    View at Publisher | View at Google Scholar
  47. Paola DR, Noemi G, Valeria B, Lorena C, Manara DF, et. al., (2022). Risk factors and management of postpartum urinary retention: A scoping review. International Journal of Urological Nursing. 16(2):87-104.
    View at Publisher | View at Google Scholar
  48. Peinado-Molina RA, Hernández-Martínez A, Martínez-Vázquez S, Rodríguez-Almagro J, Martínez-Galiano JM. (2023). Pelvic floor dysfunction: prevalence and associated factors. BMC Public Health.23(1):2005.
    View at Publisher | View at Google Scholar
  49. Pergialiotis V, Bellos I, Antsaklis A, Papapanagiotou A, Loutradis D, et. al., (2020). Maternal and neonatal outcomes following a prolonged second stage of labor: A meta-analysis of observational studies. European Journal of Obstetrics & Gynecology and Reproductive Biology. 252: 62-69.
    View at Publisher | View at Google Scholar
  50. Rosenberg M, Many A, Shinar S. (2020). Risk factors for overt postpartum urinary retention—the effect of the number of catheterizations during labor. International Urogynecology Journal. 31:529-33.
    View at Publisher | View at Google Scholar
  51. Sadiq G, John S. (2020). Effects of Mode of Delivery and Perineal Injury on the Prevalence of Urinary and Fecal Incontinence. Journal of The Society of Obstetricians and Gynaecologists of Pakistan. 10(1):56-61.
    View at Publisher | View at Google Scholar
  52. Salman L, Shmueli A, Aharony S, Pardo A, Chen R, et. al., (2022). Postpartum voiding dysfunction following vaginal versus caesarean delivery. Journal of Obstetrics and Gynaecology. 42(2):256-60.
    View at Publisher | View at Google Scholar
  53. Selius BA, Subedi R. (2008). Urinary retention in adults: diagnosis and initial management. American family physician. 77(5):643-650.
    View at Publisher | View at Google Scholar
  54. Serlin DC, Heidelbaugh JJ, Stoffel JT. (2018). Urinary retention in adults: evaluation and initial management. American family physician. 98(8):496-503.
    View at Publisher | View at Google Scholar
  55. Shehata IM, Barsoumv S, Elhass A, Varrassi G, Paladini A, et. al., (2021). Anesthetic Considerations for Cesarean Delivery After Uterine Transplant. Cureus. 13(3).
    View at Publisher | View at Google Scholar
  56. Sleutel MR, True B, Webb J, Valdez E, Tran MV. (2020). Integrative review of lower extremity nerve injury during vaginal birth. Journal of Obstetric, Gynecologic & Neonatal Nursing. 49(6):507-524.
    View at Publisher | View at Google Scholar
  57. Stoffel JT, Peterson AC, Sandhu JS, Suskind AM, Wei JT, et. al., (2017). AUA white paper on nonneurogenic chronic urinary retention: consensus definition, treatment algorithm, and outcome endpoints. The Journal of Urology. 198(1):153-160.
    View at Publisher | View at Google Scholar
  58. Storm S, MacVicar S. (2024). Management of stress urinary incontinence associated with perimenopause. Journal of Prescribing Practice. 6(2):68-74.
    View at Publisher | View at Google Scholar
  59. Suar G, Cevik F, Simal Yavuz N, Ozerdogan N. (2023). Urinary incontinence in the postpartum 1‐year period: Its prevalence and effect on the psychosocial status of women. LUTS: Lower Urinary Tract Symptoms. 15(5):191-199.
    View at Publisher | View at Google Scholar
  60. Sudhakaran P. (2019). Urinary retention in pregnancy and puerperium: acupuncture treatment. Medical Acupuncture. 31(5):269-273.
    View at Publisher | View at Google Scholar
  61. Swathi HV, Samant PY. (2020). Postnatal bladder dysfunction. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 9(7):3026.
    View at Publisher | View at Google Scholar
  62. Tiberon A, Carbonnel M, Vidart A, Halima MB, Deffieux X, et. al., (2018). Risk factors and management of persistent postpartum urinary retention. Journal of Gynecology Obstetrics and Human Reproduction. 47(9):437-441.
    View at Publisher | View at Google Scholar
  63. Trowbridge ER, Hoover EF. (2022). Evaluation and treatment of urinary incontinence in women. Gastroenterology Clinics. 51(1):157-175.
    View at Publisher | View at Google Scholar
  64. ul Ain Q, Shetty N, Supriya K. (2021). Postpartum urinary retention and its associated obstetric risk factors among women undergoing vaginal delivery in tertiary care hospital. Journal of Gynecology Obstetrics and Human Reproduction. 50(2):101837.
    View at Publisher | View at Google Scholar
  65. Veronica M, Tirkey RS, Varunashree N, Mathews JE, Thenmozhi M. et. al., (2023). Diagnostic Accuracy of Urine Volume Estimation by Ultrasound to Prevent Unnecessary Catheterisation in the Intrapartum Period: A Cross-sectional Study. Journal of Clinical & Diagnostic Research. 17(5).
    View at Publisher | View at Google Scholar
  66. Wessells H, Angermeier KW, Elliott S, Gonzalez CM, Kodama R, et. al., (2017). Male urethral stricture: American urological association guideline. The Journal of urology. 197(1):182-190.
    View at Publisher | View at Google Scholar
  67. Wulf MJ, Tom VJ. (2023). Consequences of spinal cord injury on the sympathetic nervous system. Frontiers in cellular neuroscience. 17:999253.
    View at Publisher | View at Google Scholar
  68. Yip SK, Brieger G, Hin LY, Chung T. (1997). Urinary retention in the post-partum period: the relationship between obstetric factors and the post-partum post-void residual bladder volume. Acta obstetricia et gynecologica Scandinavica. 76(7):667-672.
    View at Publisher | View at Google Scholar
  69. Zakzouk NA, Habib FM, Ezzat R. (2023). Voiding Dysfunction between Women Following Vaginal Vs Cesarean Section Delivery: A Comparative Study. Menoufia Nursing Journal. 8(3):217-233.
    View at Publisher | View at Google Scholar

Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.

img

Virginia E. Koenig

Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.

img

Delcio G Silva Junior

Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.

img

Ziemlé Clément Méda

Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.

img

Mina Sherif Soliman Georgy

We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.

img

Layla Shojaie

The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.

img

Sing-yung Wu

Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.

img

Orlando Villarreal

Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.

img

Katarzyna Byczkowska

Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.

img

Anthony Kodzo-Grey Venyo

Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.

img

Pedro Marques Gomes

Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.

img

Bernard Terkimbi Utoo

This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.

img

Prof Sherif W Mansour

Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.

img

Hao Jiang

As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.

img

Dr Shiming Tang

Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.

img

Raed Mualem

International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.

img

Andreas Filippaios

Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.

img

Dr Suramya Dhamija

Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.

img

Bruno Chauffert

I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!

img

Baheci Selen

"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".

img

Jesus Simal-Gandara

I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.

img

Douglas Miyazaki

We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.

img

Dr Griffith

I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.

img

Dr Tong Ming Liu

I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.

img

Husain Taha Radhi

I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.

img

S Munshi

Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.

img

Tania Munoz

“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.

img

George Varvatsoulias

Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.

img

Rui Tao

Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.

img

Khurram Arshad

Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.

img

Gomez Barriga Maria Dolores

The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.

img

Lin Shaw Chin

Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.

img

Maria Dolores Gomez Barriga

Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.

img

Dr Maria Dolores Gomez Barriga

Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.

img

Dr Maria Regina Penchyna Nieto

Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.

img

Dr Marcelo Flavio Gomes Jardim Filho

Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”

img

Zsuzsanna Bene

Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner

img

Dr Susan Weiner

My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.

img

Lin-Show Chin

My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.

img

Sonila Qirko

My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.

img

Luiz Sellmann

I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.

img

Zhao Jia