Monday, January 30, 2023

Loss Of Bladder Control During Pregnancy

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Should I Drink Less Water Or Other Fluids If I Have Urinary Incontinence

Bladder leakage during pregnancy (urinary incontinence tips)

No. Many people with urinary incontinence think they need to drink less to reduce how much urine leaks out. But you need fluids, especially water, for good health.

Women need 91 ounces of fluids a day from food and drinks.11 Getting enough fluids helps keep your kidneys and bladder healthy, prevents urinary tract infections, and prevents constipation, which may make urinary incontinence worse.

After age 60, people are less likely to get enough water, putting them at risk for dehydration and conditions that make urinary incontinence worse.12

Why Get Treatment For Loss Of Bladder Control

Bladder control problems can be embarrassing and can cause you to needlessly cut back on the activities that you enjoy. They may also be a sign of a serious underlying health condition. Bladder incontinence may be a symptom of kidney disease, diabetes, Alzheimers, Parkinsons, multiple sclerosis , and other diseases.

What To Do About Urinary Incontinence During Pregnancy

Rest assured, pregnancy incontinence or light bladder leaks are common experiences during pregnancy. The good news is that experiencing incontinence is usually temporary. This doesnt make it less inconvenient or embarrassing at the moment, but at least you know theyll probably subside after you give birth and your pelvic muscles recover.

To help you cope here and now with pregnancy incontinence, do the following:

Also Check: Where Do You Feel Bladder Pain

How Long Does Incontinence Last After Pregnancy

Developing incontinence after your pregnancy depends on what happened during your pregnancy and delivery.

As your body gets ready to give birth, it changes. On top of experiencing weight gain, your hips loosen, and your cervix, bones, pelvic floor muscles, and pelvic ligaments begin to stretch. This happens in your body so your baby is more comfortable during its growing period and during delivery. All of these changes can lead to postpartum incontinence, depending on how much your body is affected.

Incontinence usually improves after delivery, although it does take time. When you give birth, there are a couple of things that can increase the likelihood that youll experience incontinence afterward:

  • If your baby is very large, it can affect how much your vaginal canal and vaginal opening stretch, which can, in turn, affect your bladder control.
  • If you have an episiotomy , you may have much weaker pelvic floor muscles and experience incontinence.
  • If you are in labor that lasts for a long time, pelvic nerve damage may occur and lead to incontinence.

After delivering a baby, your body continues to experience hormonal changes that affect your bladder. Your uterus will begin to go back to its standard size after birth, which can put extra pressure on your bladder, causing incontinence symptoms even after delivery.

What Causes Urinary Retention

Bladder Leakage After Pregnancy &  Childbirth

Hormonal changes in pregnancy cause the bladder muscle to lose some of its tone and so bladder capacity increases from the third month of pregnancy. This increase may not be obvious to the pregnant woman apart from experiencing an increased number of visits to the toilet to empty her bladder.

After delivery, the loss of tone of the bladder muscle can cause difficulties in emptying out.

There are procedures that may contribute to the development of difficulties in passing urine, such as: epidural for pain relief, long labour, prolonged second stage of labour, forceps or ventouse delivery and extensive vaginal lacerations. An effect of epidural or spinal anaesthetic is that it blocks normal sensation from the bladder and interferes with the normal bladder filling and emptying function. Bladder function should be closely monitored if an epidural is used.

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How Soon After Starting Kegel Exercises Will Urinary Incontinence Get Better

It may take 4 to 6 weeks before you notice any improvement in your symptoms.10

Kegel exercises work differently for each person. Your symptoms may go away totally, you may notice an improvement in your symptoms but still have some leakage, or you may not see any improvement at all. But even if your symptoms dont get better, Kegel exercises can help prevent your incontinence from getting worse.

You may need to continue doing Kegel exercises for the rest of your life. Even if your symptoms improve, urinary incontinence can come back if you stop doing the exercises.

Consider The Possibility Of A Urinary Tract Infection

Sometimes, having no control over when you wee is caused by a urinary tract infection . UTIs can affect different parts of your urinary tract, including your bladder , urethra or kidneys . Most UTIs can be easily treated with antibiotics .

Symptoms of a UTI include:

  • needing to wee suddenly or more often than usual
  • blood in your wee

Contact your doctor or midwife immediately if you have any of these symptoms because you might need antibiotics .

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Collagen Changes During Pregnancy

Collagen changes included both tensile properties and number. Changes in tensile properties contribute to reduced functional support of PFM, and reduced total collagen content may result in joint laxity and stretching of pelvic ligaments . Several studies have reported a decrease in the total collagen content in women with SUI . Keane et al. showed that nulliparous women with SUI had significantly less collagen content in their tissues than did continence pregnant women . They also concluded that the etiology of SUI in these pregnant women appears due to both quantitative and qualitative reduction in collagen.

How Is Urinary Incontinence During Pregnancy Treated

Pregnancy and Bladder Control

Behavioral methods such as timed voiding and bladder training can be helpful in treating urinary incontinence during and after pregnancy. These techniques are often used first and can be done at home. The changes in habits that behavioral methods involve do not have serious side effects.

To practice timed voiding, you use a chart or diary to record the times that you urinate and when you leak urine. This will give you an idea of your leakage “patterns” so that you can avoid leaking in the future by going to the bathroom at those times.

In bladder training, you “stretch out” the intervals at which you go to the bathroom by waiting a little longer before you go. For instance, to start, you can plan to go to the bathroom once an hour. You follow this pattern for a period of time. Then you change the schedule to going to the bathroom every 90 minutes. Eventually you change it to every two hours and continue to lengthen the time until you are up to three or four hours between bathroom visits.

Another method is to try to postpone a visit to the bathroom for 15 minutes with the first urge. Do this for two weeks and then increase the amount of time to 30 minutes and so on.

In certain cases, a woman may use a pessary, a device to block the urethra or to strengthen the pelvic muscles. In addition, medications also can be helpful in controlling muscle spasms in the bladder or strengthening the muscles in the urethra. Some drugs can help to relax an overactive bladder.

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What Causes Urinary Incontinence After Pregnancy

It may surprise you to learn that it doesnt matter what type of delivery you have women who have given birth have much higher rates of post-pregnancy stress incontinence than those who have never had a baby. Simply explained, giving birth can contribute to incontinence after pregnancy. The American Congress of Obstetricians and Gynecologists has found that cesarean delivery reduces incontinence during the first year, but benefits are diminished two to five years after delivery. A normal labor and vaginal delivery can weaken the pelvic floor muscles and damage the nerves that control the bladder. A long labor and prolonged pushing can increase the likelihood of immediate pelvic floor muscle weakness following delivery. Additionally, a uterus shrinks in the weeks following delivery and as it sits directly on the bladder, compression can make it more difficult to control the flow of urine. Loss of bladder control is also caused by pelvic organ prolapse that can occur after childbirth. In this case, the pelvic muscles stretch and become weaker during pregnancy and vaginal delivery. If the muscles do not provide enough support, the bladder may move down or sag, causing mobility of the urethra, leading to incontinence with increased abdominal pressure.

Could Incontinence Be A Sign Of Something More Serious

Urinary incontinence can lead to faecal incontinence as the muscles progressively weaken. A weak pelvic floor can also cause sexual difficulties such as reduced vaginal sensation. Incontinence can be a sign of a prolapse where the internal organs are no longer supported by the pelvic floor and the bladder or uterus can slide down into the vagina. If you suspect you have a prolapse, you should also look out for a distinct bulge in the vagina or deep vaginal aching.

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Why Does Urinary Incontinence Occur With Pregnancy

Pregnancy and childbirth can cause incontinence in several ways:

  • Your growing baby takes up a lot of room. As the uterus expands, it puts increased pressure on the bladder, urethra, and pelvic floor muscles. This can lead to leakage.
  • Changing progesterone levels during pregnancy can weaken the pelvic floor. Increases in this hormone loosen up your ligaments and joints so the belly can expand and so you can deliver. But it can also loosen ligaments in the pelvis that help you hold in urine.
  • Childbirth, particularly vaginal delivery, can stretch and weaken the pelvic floor muscles. This can lead to pelvic organ prolapse, in which your bladder, uterus, or rectum droops into the vaginal canal. Prolapse can be associated with urinary incontinence.
  • Vaginal delivery also can result in pelvic muscle and nerve injury, which can result in bladder control problems.

If you experience urinary incontinence during pregnancy, you are at higher risk of having a persistent problem after birth. Tell your health care provider about urinary incontinence symptoms as soon as you notice them during pregnancy or at your first postnatal visit.

More than 80% of postpartum women who experience SUI symptoms during pregnancy may continue to experience stress incontinence without treatment.

Related reading:Body after birth: Treating post-pregnancy problems

Effects Of Pregnancy On Bladder

Postpartum Loss of Bladder Control

Women need frequent trips to the bathroom during pregnancy. It can be a problem to control bladder and therefore, they need to empty their bladder often. Often they leak urine while sneezing or coughing. Many activities cause pressure on the muscles of the pelvis which causes an urge to urinate. Such a condition is called stress incontinence. When a woman is pregnant, the baby inside often presses on the uterus or the pelvic floor. However, this stress issue often ends within 30 days after delivery. The stress inconsistence often depends upon the type of delivery. Women with vaginal delivery have a high chance of the problem than the ones with caesarian babies or women with no babies at all.

Often many women face a prolapse of the pelvic organ after childbirth. Such a situation may lead to a loss of control over the bladder. While a woman is pregnant, the extreme pressure often loosens the pelvic muscles. Thus, resulting in frequent urination.

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How To Stop Bladder Leakage After Hysterectomy

Regardless of the cause of your bladder leakage, there are options to improve it considerably in most cases. One approach that can help: Train the muscles that support your bladder. At no time in a womanâs life should she consider urinary incontinence as something normal or what she can expect as she ages.

There are several things you can try to get better bladder control and fix light bladder leakage. Here are a few hints you can easily incorporate into your daily life that will help to correct embarrassing bladder leakage after a hysterectomy.

Pregnant Women: When To Seek Medical Advice For Urinary Incontinence

Do mention to your doctor at your regular check-ups if you are experiencing urine leakage or urinary incontinence, just to keep them in the loop on all your pregnancy experiences.

Beyond keeping your doctor apprised of any experience of urinary incontinence, always seek more immediate medical advice if you experience the following:

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How Bladder Leakage Problems Are Diagnosed

Although many problems related to bladder leakage during or after pregnancy vanish over time, it is imperative that you visit an expert if the problem persists for more than six weeks after childbirth. It is helpful to document your trips to the bathroom, the number of times you experience urine leakage, and when it happens.

Your doctor will do a physical exam to rule out any underlying conditions you may have, and assess your bladders health. Some tests that help your doctor in diagnosing bladder leakage include:

An ultrasound This test produces images through ultrasound waves that can give a clear picture of your urethra, kidney, and bladder.

Urinalysis In this test, you are required to provide your urine sample for analysis. This helps in ruling out infections that cause bladder leakage.

Cystoscopy This is a diagnostic procedure where a thin tube that has a miniature camera is inserted into your urethra. This enables the doctor to examine your urethra and bladder.

Bladder Stress Test This is a test where your doctor checks for any sign of bladder leakage when you bear down or cough.

Urodynamics In this test, a thin tube is inserted into your bladder. The tube fills your bladder with water and the pressure inside is measured.

An Extremely Common Condition

Bladder Control Issues | Katie Propst, MD

Sorry to report this, but postpartum urinary incontinence is quite common. According to the latest research, women who give birth vaginally are more likely to experience these complications afterward. In some cases, issues of urinary incontinence can last up to a year, and smaller percentages of women are still living symptoms after 5 years.

Contributing factors include the fact that the bladder and pelvis muscles are weakened during childbirth. In addition, the uterus will begin to shrink back to its normal size, which causes repeated compressions on the bladder. Rapid changes in hormones also need to be considered as the body attempts to balance its female sex hormones after a child is born. Women over the age of 35 and those who are obese are also at a greater risk for urinary incontinence following childbirth.

All together, these influential factors lead women to face a much higher risk for urinary incontinence. The good news is that most women can recover with the proper precautions and effective treatment options recommended by Dedicated to Women.

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What Are The Symptoms Of Vaginal Prolapse

In many cases, you may not feel any symptoms from a prolapse. You may find out about a vaginal prolapse during an exam in your healthcare providers office. If you do experience symptoms, they can include:

  • A feeling of fullness, heaviness or pain in the pelvic area. This feeling often gets worse as the day goes on or after standing, lifting or coughing.
  • Lower back pain.
  • Organs slipping out of the vagina.
  • Leakage of urine .
  • Bladder infections.
  • Difficulty having a bowel movement.
  • Problems with sexual intercourse.

Lifestyle Changes For Ui During Pregnancy

There are many reasons not to smoke during pregnancy, but one of them is to reduce the risk of urinary incontinence. Cigarette smoking has been associated with stress incontinence, urgency incontinence and leakage of urine during sex. Smoking contributes to urinary incontinence by irritating the bladder, and also because it leads to chronic coughing, which can make urine leaking worse.

Certain dietary changes can also help. You should already have cut out alcohol and cut down on caffeine, but try cutting down on spicy or acidic foods too. If youre experiencing constipation, this can also worsen urinary incontinence, by putting increased pressure on the bladder.

When pelvic floor strengthening and lifestyle changes arent working, there are still more options, including medications to improve bladder control, electrical stimulation to strengthen the pelvic floor, and pessaries that are inserted in the vagina to support the bladder.

If none of these options work, there are also certain surgical procedures that your provider can explain. You can also make an appointment to see a urogynecologist. Urogynecologists specialize in pelvic floor dysfunction, including urinary incontinence.

This content was reviewed by Dr. Lisa Hickman and Dr. Katie Propst. Dr. Hickman runs the Childbirth Pelvic Floor Disorders Clinic at The Ohio State University Wexner Medical Center. Dr. Propst runs the Postpartum Care Clinic at Cleveland Clinic.

Also Check: Uti Bladder Infection Kidney Infection

The Prevalence Of Urinary Incontinence In Pregnancy

The most common type of UI in pregnant women is SUI. However, the true prevalence of SUI is still unknown. There are many studies on the prevalence of SUI during pregnancy, and results vary depending on study method and design, such as definitions of UI, evaluation questionnaire, and stage of pregnancy .

Most studies focused on European or Western counties. Only a few studies determined SUI during pregnancy in Asia, especially in Southeast Asia. Wesnes et al. presented questionnaire data from the Norwegian Mother and Child Cohort Study at the Norwegian Institute of Public Health and found that the most common type of UI was SUI in high prevalence in both nulliparous and multiparous women, 31 % and 42 %, respectively. Morkved and Bø from Norway found the prevalence of SUI during pregnancy was 42 %. According to the same study, SUI was 38 % 8 weeks after delivery. Other studies from Europe , UK , Spain , Scotland , Germany , and Denmark found similarly high prevalence of SUI during pregnancy.

What Are The Risk Factors For Pregnancy Incontinence

How pregnancy affects bladder control? What are the tips to manage it?

When youre pregnant, pelvic floor muscles are working overtime. That said, most women who are carrying a child are at risk for some form of pregnancy incontinence. Women who have had an overactive bladder or urgency incontinence prior to pregnancy will most likely have symptoms that continue or worsen during pregnancy. Other risk factors include:

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