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What to do for severe urinary incontinence after childbirth?
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Kidney & Urinary Health
Question #30497
48 days ago
147

What to do for severe urinary incontinence after childbirth?

Andra

Bună ziua dragi doctori, ma confrunt cu-o problema serioasa . De mică am incontinenta urinară .Nu puteam să mă țin deloc, la primul strănut sau tușit urinam pe pantaloni . Am născut acum 2 luni și problema s-a agravat.In prezent nu mă mai pot ține deloc. Curge toată urina .Am încercat exercițiile Kegel ,dar în zadar .Ce altceva pot face ? Exista tratament ? Pastile sau ceva ca ma poate ajuta ? Este foarte frustrant . Mulțumesc pentru răspunsuri How long have you been experiencing worsening urinary incontinence since childbirth?: - 2-3 months How would you describe the severity of your incontinence?: - Very severe — unable to control at all Have you noticed any specific activities that trigger your incontinence?: - Coughing or sneezing Are there any other symptoms you are experiencing?: - No other symptoms Have you discussed this issue with your healthcare provider since giving birth?: - No, I haven't consulted anyone How is your overall health and energy level since giving birth?: - Good — some fatigue Have you tried any other treatments or interventions for your incontinence?: - No, just Kegel exercises

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Doctors' responses

Bună ziua, Înțeleg cât de frustrantă poate fi această situație, mai ales că problema exista încă din copilărie și s-a agravat după naștere. Din ceea ce descrieți, este puțin probabil să fie vorba doar despre incontinența urinară obișnuită de după naștere. Faptul că pierdeți urină la strănut sau tuse încă din copilărie, iar acum la 2 luni după naștere nu mai puteți controla deloc urinarea, necesită o evaluare amănunțită de către un medic uro-ginecolog sau urolog.

Există tratamente pentru incontinența urinară, însă acestea depind de cauza exactă. Înainte de a prescrie medicamente, este important să se stabilească tipul de incontinență și gradul afectării. Medicul poate recomanda: • Examinare clinică ginecologică și urologică. • Analiză de urină și urocultură. • Ecografie pelvină și a aparatului urinar. • Determinarea urinei reziduale după urinare. • Investigații urodinamice pentru evaluarea funcției vezicii urinare.

Exercițiile Kegel sunt utile în multe cazuri, dar dacă nu au adus niciun beneficiu și simptomele sunt atât de severe, este posibil să fie necesare alte forme de tratament, inclusiv recuperare specializată a planșeului pelvin sau, în anumite cazuri, tratament chirurgical.

Prescripție/Recomandări finale: • Programați cât mai curând un consult la un medic uro-ginecolog sau urolog. • Continuați exercițiile Kegel până la evaluare. • Evitați excesul de cafea, băuturi energizante și alte iritante ale vezicii urinare. • Țineți un jurnal al episoadelor de pierdere de urină și al consumului de lichide. • Folosiți absorbante urinare dacă este necesar pentru confort. • Nu începeți medicamente pentru incontinență fără recomandarea unui specialist, deoarece tratamentul depinde de cauza exactă.

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For severe urinary incontinence postpartum, like you’re experiencing, it’s crucial to get a thorough evaluation, ideally from a urologist or a gynecologist specializing in pelvic floor issues. Since Kegel exercises haven’t worked for you, it’s possible that the underlying pelvic floor muscles could be too weak or that there is damage that requires more specific interventions. A few approaches might help you.

Firstly, pelvic floor physical therapy with a specialist can often provide significant improvement. This therapist can teach you advanced techniques or use biofeedback and electrical stimulation to help strengthen those muscles. Medications like anticholinergics could be considered if overactive bladder symptoms contribute to your condition, but they generally work better for urge incontinence rather than stress incontinence.

Surgical options, such as urethral bulking agents or sling procedures, may be recommended for severe cases when other treatments fail, but it’s essential to evaluate the benefits versus risks with your doctor. Additionally, temporary solutions, such as incontinence pads or devices like a pessary that help support the bladder neck, can offer some relief while you explore more permanent solutions.

Please consult a healthcare provider as soon as possible to explore these options alongside a diagnostic workup that might include urodynamic testing or imaging studies. This help pinpoint the exact issue and guide treatment. It’s important not to delay this consult because resolving the issue typically improves quality of life significantly.

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Hello Thank you for sharing your experience so openly—urinary incontinence can be very distressing, especially when it affects daily life. Based on your history, it sounds like you have had stress incontinence (leakage with coughing/sneezing) since childhood, and now after childbirth, it has progressed to almost complete loss of bladder control (possibly urge or overflow incontinence as well).

Here’s what you need to know:

### Why Is This Happening? - Since childhood: This suggests a possible underlying weakness in the pelvic floor muscles, a congenital (from birth) issue with the bladder or urethra, or sometimes a neurological problem. - After childbirth: Pregnancy and delivery can further weaken pelvic muscles and nerves, making incontinence worse.

### What Can Be Done? 1. Specialist Consultation:
You need to see a urologist or urogynecologist for a detailed evaluation. They may suggest: - Urine tests and bladder diary - Ultrasound or urodynamic studies (to check bladder function) - Physical examination

2. Treatment Options:
- Pelvic Floor Therapy: Since Kegel exercises haven’t helped, supervised pelvic floor physiotherapy (with a trained therapist) may be more effective than home exercises. - Medications: Some medicines can help, especially if there is urge incontinence, but they are not always effective for stress incontinence. - Devices: Vaginal pessaries or urethral inserts can sometimes help women with stress incontinence. - Surgery: If conservative measures fail, surgical options like sling procedures or bladder neck suspension can provide long-term relief, especially for severe cases. - Bladder Training: Timed voiding and bladder retraining can help in some cases.

3. Home Care Tips:
- Avoid caffeine, alcohol, and carbonated drinks. - Maintain a healthy weight. - Use absorbent pads for comfort and to prevent skin irritation.

### Indian Context - Many government hospitals and medical colleges offer urology/urogynecology services at low or no cost. - Pelvic floor physiotherapy is available in larger cities.

### What Not to Do - Don’t self-medicate with over-the-counter pills for incontinence—they are not effective for your type and may cause side effects. - Don’t lose hope—this is a medical condition, not your fault, and effective treatments are available.

Summary:
You need a specialist evaluation to find the exact cause and best treatment. Surgery is often very effective for severe, long-standing incontinence, especially when other treatments haven’t worked. Please don’t hesitate to seek help—this is a common and treatable problem.

Thank you

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Hello dear I think it is urinary retention It can be due to excessive water retention by kidney by raas system Secondary hypertension Iam suggesting some tests Please share the result with urologist in person for better clarity Cbc Esr Serum ferritin Serum tsh Serum hb Rft Lft Gfr Serum creatinine Serum bilirubin Hemogram Kidney USG Hopefully you recover soon Regards

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Hello

Severe urinary incontinence that has been present since childhood and has become much worse after childbirth should be evaluated by a doctor, preferably a urogynecologist or urologist. Since you describe continuous urine leakage and being unable to control it at all, this is beyond what would typically be expected from normal postpartum weakness alone.

There are several possible causes, including significant pelvic floor weakness, structural problems of the urinary tract, nerve-related issues, or other conditions that may have been present for years and were worsened by pregnancy and delivery. The fact that Kegel exercises have not helped does not mean nothing can be done.

Treatment depends on the cause and may include specialized pelvic floor physiotherapy, bladder training, medications in selected cases, pessaries, or surgical procedures. Before recommending treatment, a doctor may perform an examination and possibly tests such as urine studies, bladder function testing, or imaging.

Because your symptoms are very severe and are significantly affecting your quality of life, I would encourage you to arrange a medical evaluation soon rather than trying additional treatments on your own. Many causes of urinary incontinence are treatable, but the correct treatment depends on identifying the underlying reason for the leakage.

If you notice constant leakage day and night, difficulty emptying your bladder, recurrent urinary infections, blood in the urine, or new numbness or weakness in your legs, seek medical attention promptly.

Take care

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