23.04.2024

Urinary incontinence after pregnancy and childbirth

A problem such as urinary incontinence after childbirth is familiar to approximately 40% of women giving birth. Many women are silent about this problem and are ashamed to admit it even to a doctor. But in vain. Indeed, due to the inability to fully control the process of urination, a woman harms her health and deliberately reduces the quality of her life.

What is urinary incontinence

Incontinence is understood as a pathological condition, manifested by involuntary, uncontrolled urine output. The amount of discharge can be different: from a few drops once a day to constant leakage throughout the day.

In women who have given birth, stress incontinence is usually observed. In this case, involuntary urination can occur with any tension of the abdominal muscles: during physical exertion (bending, crouching), when laughing, coughing, sneezing or having sex. With a severe form of pathology, involuntary urination can occur with a change in body position and even during sleep.

Causes

Spontaneous urination is most often associated with impaired function of the muscles of the pelvic floor. During the bearing of the child, the muscles that support the developing fetus and form the birth canal have a significant load. They stretch, become less elastic, resilient and unable to fully perform their functions.

Urinary incontinence can develop after a long and difficult birth, accompanied by ruptures of the perineum or pelvic muscles. At risk are also women who give birth again.

Symptoms of pathology

You can talk about urinary incontinence if uncontrolled urine output in any volume occurs during sneezing, laughing or during a change in body position.

Also, a woman may complain of a feeling of fullness of the bladder after it is empty or a feeling of having a foreign body in the vagina.

Diagnostics

A urologist or urogynecologist should deal with this problem. A woman who seeks qualified help should be extremely frank, since maximum openness in this case helps to make the right diagnosis and prescribe effective therapy.

During the reception, the doctor, as a rule, asks the patient about injuries, diseases, operations, the number and course of childbirth, birth weight, injuries during childbirth and complications after them. He may also be interested in information on the frequency of urination, the presence or absence of discomfort during urination.

To make a diagnosis, a visual examination is necessarily performed on a gynecological chair, laboratory tests of urine and blood, cystoscopy and ultrasound of the abdominal cavity are prescribed. To clarify the diagnosis, profilometry, cystomerism and uroflowmetry can be prescribed.

Treatment

What to do if urinary incontinence after childbirth did not pass spontaneously, but has become a real exhausting problem? Incontinence is a pathology that does not pose a threat to the health and life of a woman. However, it, as mentioned above, leads to a deterioration in the quality of life. That is why a woman who is faced with this problem should know that there are many modern ways of treating this pathology. To do this, you need to contact a specialist who will select the most suitable treatment method.

Treatment of urinary incontinence after childbirth can be done conservatively or surgically.

Conservative treatment includes the following procedures :

  • Holding weights. A woman should hold the weights placed in the vagina, made in the form of a cone and having different weights. You should start with weights that are light weight, gradually moving to heavier ones. The load must necessarily be agreed with the attending physician. Exercise should be performed every day 3-4 times for 15-20 minutes.
  • Kegel exercises. Throughout the day, a woman should strain 100-200 times and hold for a few seconds in this state the muscles around the rectum and bladder.
  • Bladder training. The doctor develops a urination plan, according to which the patient should empty the bladder at certain, gradually increasing intervals. However, she should urinate only in accordance with the developed plan. Thus, a woman learns to restrain urination and empty the bladder at long intervals. Such treatment usually lasts at least 2 months.
  • Physiotherapy. Physiotherapy can be used to strengthen the pelvic muscles, in particular, electromagnetic stimulation. Effectively alternating physiotherapy with exercises for urinary incontinence.
  • Drug therapy. In case of urinary incontinence, sedative medications that improve blood circulation, strengthen the vascular wall, vitamin complexes, etc. can be prescribed. However, in modern pharmacology there are no medicines whose action would be aimed directly at eliminating the causes of urinary incontinence.

If conservative treatment of the pathology is ineffective or ineffective, surgical treatment is performed.

A number of operations in surgical treatment :

  • Loop operation. At the moment, this is the most common surgical method for the treatment of uncontrolled urination. An additional support is placed under the urethra in the form of a loop made of the skin of the upper thigh, labia minora, etc. In some cases, a loop of durable synthetic material is used to create the support, which does not cause rejection and does not resolve with time. The operation is performed through a small incision on the skin, it is less traumatic and is indicated for any degree of pathology.
  • The operation performed using the gel. Around the urethra, a support is created from a special medical gel. The operation is performed more often under local anesthesia, both on an outpatient and inpatient basis. Its duration does not exceed 30 minutes.
  • Urethrocystocervicopexy. During this operation, the pubic-vesiculate ligaments are strengthened, which keep the bladder neck and urethra in a normal physiological position. This is a technically complex operation, performed under general anesthesia and requires a long postoperative recovery period. That is why they resort to it extremely rarely.
Prevention

To avoid problems with urination, it is important to follow these recommendations:

  • Keep track of body weight. Extra pounds create a significant burden on the bladder and enhance the clinical manifestations of pathology.
  • Timely treat and prevent infectious diseases of the urinary organs.
  • During pregnancy, it is imperative to comply with all the recommendations of the gynecologist, undergo all examinations and take the prescribed tests. This will allow timely detection of pathology and begin its treatment.
  • Wear a bandage during pregnancy.

Thus, urinary incontinence is not an incurable pathology; it can be easily corrected using modern treatment methods. Therefore, every woman should know that the problem of urinary incontinence is solvable. Do not hide it, qualified specialists will help you solve it quickly and effectively.

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