Managing bladder problems after childbirth

Hema Brazell, MD

Urogynecology

Many women experience bladder leakage during pregnancy, but also after giving birth. When should you be concerned? Urogynecologist Hema D. Brazell, MD, offered some advice.

What is urinary incontinence?

There are many types of urinary incontinence, which can range from involuntarily leaking just a few drops of urine to completely emptying your bladder. Stress urinary incontinence (SUI) is leaking urine when coughing, laughing or sneezing and is the most common type of urine leakage during and after pregnancy. These leaks can also happen when a woman walks, runs or exercises.

Dr. Brazell said SUI is one of many pelvic floor disorders. Pelvic floor disorders are caused by the weakening of muscles and tissues of the pelvic floor due to pregnancy, childbirth and/or aging.

“Stress incontinence usually resolves within a few weeks of giving birth when your baby is no longer putting extra pressure on the bladder and you’ve lost some weight. However, if you’re still experiencing leakage, tell your doctor when you have your postnatal check at six to eight weeks,” said Dr. Brazell. “Your gynecologist may first recommend nonsurgical treatment.”

How is urinary incontinence treated?

Dr. Brazell shared nonsurgical and surgical treatment options to help diminish any leaking.

Nonsurgical treatment options:

• Lifestyle changes    
  • Drinking less fluid
  • Limiting caffeine
  • Stopping smoking
  • Losing weight
• Bladder training
• Pelvic floor physical therapy
• Kegel exercises – pelvic muscle exercises
• Pessary – a device that is inserted into the vagina to support the walls of the vagina and lift the bladder and urethra

Surgical treatment options:

• Injections – a synthetic substance is injected into the tissues around the urethra to “plump up” and narrow the opening of the urethra.
• Urethral sling surgery – a sling is placed under the urethra to provide support.
• Colposuspension – a procedure where stitches are placed on either side of the bladder neck and attached to nearby supporting structures to lift up the urethra and hold it in place.