Bladder Control And Pregnancy

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Bladder Control And Pregnancy

Jennifer Anger, M.D, M.P.H. (Assistant Professor) gives expert video advice on: Now that I am pregnant, I leak urine frequently - Is that OK?; Is it normal to feel like I need to urinate all the time when I'm pregnant?; Is it true that having a baby can cause bladder control problems? and more...

Now that I am pregnant, I leak urine frequently - Is that OK?

So you've spotted the <a href="http://www.videojug.com/interview/signs-of-pregnancy">pregnancy symptoms</a> and are now pregnant and leaking urine frequently. Well i's definitely OK. And we never say to a patient who is pregnant "you need to restrict fluid" because pregnant patients need to stay well hydrated. It's simply an anatomical problem. There's too much weight on the pelvis. And I had leakage with cough / laugh / sneeze when I was pregnant. It's very common. And is there anything that we could do? Not really. Just grin and bare it like we have to bare all of the components of pregnancy.

Is it normal to feel like I need to urinate all the time when I'm pregnant?

It's very common. Urinary frequency often happens in early pregnancy possibly due to all the related changes of the uterus and those blood supplies to the uterus. The uterus is very close to the urinary bladder. Later in pregnancy, the bladder doesn't get that much room anymore. And it often gets almost squashed like a pancake. So the bladder is smaller and women have to go more frequently. Rarely, women have trouble peeing when they're pregnant. To the point of even requiring a temporary catheter. If a woman gets voiding difficulty or difficulty peeing, I would recommend that she see a physician. Because you want to avoid any problems such as complete urinary retention. Also, it's very crucial for pregnant women to make sure there's no infection in their bladder. Pregnant women who have a bladder infection have a higher risk of that bladder infection ascending to the kidneys and becoming a kidney infection. And that can be dangerous to the fetus.

Is it true that having a baby can cause bladder control problems?

Not usually. I'll be honest that vaginal delivery does predispose women to stress incontinence. A lot of women urologists and gynaecologists often opt for an elective Caesarean Section which is very controversial. But most women who do not have virginal delivery have some protection. Honestly, after delivery most women regain their continence, so with Keygel Exercises most women are dry again after the first few months, but they might be predisposed to stress incontinence later in life.

Does a caesarian section increase my risk of bladder control problems?

Studies have shown that compared to a woman who's had no pregnancies or deliveries, caesarian section patients to have a slight increase of incontinence. However, not nearly the same risk of those of having vaginal delivery.

Can an episiotomy lead to bladder control problems?

An episiotomy is usually performed on the posterior vaginal wall. So it is performed on the perennial body which is the tissue between the vagina and the rectum. So no it can't make a woman incontinent.

We usually teach patients to work on their pelvic floor muscles. But if that does not work, and we often like to say, if the incontinence is unbearable, we like to wait about after the delivery. If the patient is still incontinent, then we would recommend better treatment. Specifically, and usually for a young woman who wants to be able to exercise and be dry, we recommend surgery. I also recommend to patients, that if they are going to have more vaginal deliveries, to try to delay any surgical treatment. Although if the incontinence is severe, then we recommend definitive surgical treatment. However we may say, you might want to have a C-section next time, because you do not want to do surgery and try to push another vaginal delivery through that area.

Can pregnancy lead to bladder control problems over the long term?

It can. Often, most often, women develop stress incontinence long after the delivery. Maybe ten or twenty years later. There's quite a spectrum. Some women develop stress incontinence at the time of a delivery and it never goes away. But it usually is related to having the vaginal delivery, regardless of when the incontinence begins.

Is there anything I can do while I'm pregnant to avoid bladder control problems?

That's controversial. Usually we recommend to women to begin Kegel exercises before the delivery. Some would argue, and again, this is controversial, whether to have an elective caesarean section. That is quite controversial and there are a lot of advocates of vaginal delivery. And so for women who decide to have a vaginal delivery, I would recommend beginning Kegel exercises right away.