After childbirth, most women face various health problems and ailments. Urinary incontinence after childbirth is one such problem affecting women who have given birth. Most mothers perceive this as a shameful condition, and for a long time They hide the essence of their problem from others. This is an incorrectly taken position that violates normal functioning and negatively affecting health. Why does childbirth provoke illness, and how can you protect yourself from it?
Causes of urinary incontinence after childbirth
Urinary incontinence is a condition in which uncontrolled urination occurs. Women after childbirth often experience a condition called stress. Uncontrolled urination with this anomaly occurs during prolonged muscular work: bending, squatting, running, carrying heavy objects. Urinary incontinence is often observed in women during sex due to tension in the hip and abdominal muscles.
The reason for this condition is postpartum period pelvic floor dysfunction occurs. The failure occurs due to the load on the pelvic organs during gestation, after difficult childbirth and caesarean section. Factors influencing the likelihood of illness:
- large fruit;
- narrow pelvis of a woman in labor;
- operation - caesarean section;
- incorrect placement of the fetus in the uterus;
- pregnancy with more than one fetus;
- secondary birth;
- rupture of the vaginal walls;
- excess body weight;
- existing diseases of the genitourinary organs (pyelonephritis, urethritis, cystitis, etc.)
Types of uncontrolled urination
During the postpartum period, the following types of incontinence are likely to occur:
- Stress urinary incontinence (SUI) is the involuntary loss of urine when coughing, crying, or laughing loudly. This type of incontinence in most cases develops during the postpartum period.
- Urgent - separation of urine (urine) with frequent and intense urge to urinate, inability to restrain them.
- Reflex - occurs under the influence of inciting causes (splash of water, sound of rain).
- Uncontrolled urination - slight loss of urine throughout the day.
- Enuresis is the passage of urine at night.
- Leakage due to overcrowding Bladder- occurs under the influence of internal factors (existing infectious diseases of the genitourinary organs, the appearance of benign formations).
Symptoms of the condition
With urinary incontinence, women begin to experience the following symptoms:
- urine leaks systematically and uncontrollably;
- when leaking, it releases enough a large number of urine;
- Frequent leakage of urine during sex and physical work.
When a woman rarely experiences incidents, one way or another, they should alert and encourage the woman in labor to seek medical help. Timely contact medical institution and identifying the disease will help correct the condition and avoid negative consequences. If there are no deviations, the patient will have peace of mind about her health after the examination.
Severity of the disease
The choice of treatment measures depends on the severity of the disorders. There are three degrees of severity of illness:
- Easy. Urine leakage occurs with excessive muscular work (sports, abdominal tension, gymnastics, running).
- Average. Symptoms appear with slight tension in the abdominal muscles - during crying, laughing, or coughing.
- Heavy. The leak occurs at night (enuresis), when changing posture during sleep and for no apparent reason. The severe stage of the disease requires a competent approach in choosing treatment.
Diagnostics
Diagnostic measures are carried out by a specialist in this field, that is, a urologist. The attending physician will examine the patient and perform a test procedure (ask the woman to cough or tense her abdominals) to check for spontaneous urination. If the test reveals positive result, the woman will henceforth begin to take notes on the time and cause of involuntary urination. Based on these records, the doctor will select a specific treatment strategy for this condition.
More accurate and faster diagnosis includes the following measures:
- Ultrasound of the kidneys and pelvic organs.
- Laboratory tests of blood and urine.
- If necessary, urodynamic testing is performed - uroflowmetry. Allows you to determine disturbances in the dynamics of the lower urinary tract.
- Cystometry is a study that allows you to study pathologies in the functioning of the bladder.
- Urethral profilometry is a urodynamic study that allows you to assess the condition of the urethra.
Treatment of pathology
Treatment of the disease involves medicinal method, and surgical intervention. Many women feel ashamed and hesitate to tell the doctor about their illness during the postpartum period, because they do not know that the disease can be cured by early stages quite possible with timely diagnosis. If mild degree If the disease is treated without surgery, the severe form requires only surgical intervention.
Conservative treatment
Conservative therapy is used for stressful types of uncontrolled urination. It includes:
- exercises for the vaginal muscles;
- bladder training;
- physiotherapy;
- taking medications.
Exercises for the vaginal muscles
Holding weights using vaginal muscles. Small weights with a maximum weight of 50 grams are taken and placed in the vagina. For 15 minutes, the woman walks around the house, going about her business, while holding the weights inside. The exercise is performed 3-4 times a day. The weight of the weights at the beginning of therapy will be minimal, gradually increasing every day. This exercise will help a woman control her pelvic muscles and control the flow of urine.
By performing Kegel exercises, a woman improves the tone of her pelvic floor muscles. Kegel exercise. The basis of the exercise is squeezing and unclenching the vaginal muscles. The exercise should be done at least a hundred times a day. When urinating, you should try to hold the flow of urine for a couple of seconds, then continue the process. This exercise is very simple and does not require any special time.
The birth of a child is a long-awaited and exciting moment in the life of every woman. But this event is overshadowed by a number of consequences that arise as a result of bearing a child. One of these ailments is urinary incontinence after childbirth. This is a condition in which a woman experiences uncontrollable urine output. Therefore, many women faced with this problem are interested in the question: why does urinary incontinence occur after childbirth and how to deal with this disease?
Causes of spontaneous bowel movements after childbirth
Why is urinary incontinence observed after childbirth? Since pregnancy is extremely stressful for the body, this condition can cause problems with spontaneous urination. The main reasons for this problem may be:
- difficult childbirth, resulting in damage to the genitourinary system;
- a large fetus can injure the pelvic muscles, weakening their functionality;
- multiple births - if after the first birth a woman did not experience such a disease, then the birth of children may subsequently develop it;
- postpartum depression – apathetic or permanent state irritability negatively affects a woman’s health;
- mental disorders;
- infectious diseases of the genitourinary system;
- hormonal imbalance.
Important to remember! A genetic predisposition to this problem can lead to its development after childbirth!
Most often, spontaneous urination after childbirth occurs during certain physical manipulations, as well as in the following situations:
- urinary incontinence after childbirth when sneezing or laughing;
- at the moment of intimacy;
- when drinking alcoholic beverages, resulting in dullness nervous system, there is no signal about the desire to defecate;
- when lifting heavy objects.
Also, after childbirth, urinary incontinence is observed when coughing.
Important to remember! At the first signs of discomfort, you need to consult a specialist! This is enough spicy topic, so many women are embarrassed to talk about the problem. But you should overcome your fear, because urination after childbirth can turn into a chronic disease.
Which doctor should I contact with this problem? A specialist in this field is a urologist with prior consultation with a gynecologist.
Treatment of the disease
How to treat this disease? Modern medicine offers several ways to combat this problem. The doctor may prescribe the following types of effects on the body:
- Medicines. Involuntary urination can be treated with medicines. They have a positive effect on the bladder, helping to relax it during excessive activity. Also, some medications increase the tone of the genitourinary system. This treatment not suitable for breastfeeding.
- Laser treatment. This modern approach will help to avoid the problem surgical intervention. The essence of this procedure is the effect of a laser pulse on urethra through the vagina. The advantage of the laser is fast execution procedure and its high efficiency.
- Surgical intervention. There are many types of surgical interventions for this disease. This procedure will allow you to forget about the disease forever. The operation is performed under general anesthesia.
Important to remember! During the treatment period, you should be constantly monitored by a specialist! This determines when spontaneous urination will subside. If certain tablets are prescribed, the dosage must be prescribed by a specialist.
Exercises to strengthen the pelvic muscles
Spontaneous urination is quite often caused by injuries and poor functioning of the pelvic muscles after childbirth. To bring them back to normal and strengthen them, you can perform certain exercises. The most effective are:
- Identifying problem muscles. To do this, you should stop the process at the moment of urination. This way you can feel the location of the problem muscles. After all, it is these muscles that tense at this moment. Carry out this manipulation every time you urinate.
- Pelvic floor tension. To perform this exercise, you need to tense your pelvic floor for a few seconds, then relax for the same amount of time. Repeat the exercise 5 times in a row. It is better to do this in a sitting position.
Important to remember! When performing these exercises, you should concentrate so as not to involve the muscles of the thighs and buttocks in the process! This contributes to the maximum effectiveness of gymnastics.
Treatment with folk remedies
Alternative medicine offers many ways to combat incontinence after childbirth. Mild urinary incontinence is most effectively treated with these methods. Facilities traditional medicine can be easily prepared at home, because most of the ingredients are at hand.
Apple and onion
To prepare an effective remedy you will need 1 tbsp. l. crushed starting ingredients and 1 tsp. honey Mix all ingredients thoroughly. Use the resulting medicine 1 tbsp. l. 3 times a day.
Plantain
You will need 2 tbsp. l. finely chopped plantain leaves, which should be poured with 0.5 liters of boiling water. Infuse the decoction for 1 hour. Drink 50 ml 4 times a day. It is also effective for this disease to take freshly squeezed plantain juice.
Dill
To prepare this medicine you will need dill seeds in the amount of 1 tbsp. l. Add 1 cup of just boiled water. Leave for 2 hours, after the time has elapsed, take 100 ml 3 times a day.
Oatmeal
Grind oatmeal to flour in the amount of 3 tbsp. l. Add 1 glass of homemade milk and a small amount of raisins Mix all ingredients and put on fire. Bring to a boil, wait until the liquid cools down to room temperature. Take the prepared medicine 100 ml 3 times a day.
Spruce resin
In addition to incontinence, this remedy helps eliminate infections and inflammatory processes in the body. To prepare it you will need 1 yolk chicken egg and 1 tsp. resin. Mix the ingredients thoroughly and consume 2 times a day: morning and evening.
Important to remember! Before using a certain traditional medicine, you should consult a specialist! As a result of identifying the cause of this disease, he will prescribe the most effective therapy. The sooner you start fighting the disease, the more dynamic your recovery will be.
Prevention of urinary incontinence after childbirth
To prevent the occurrence of this disease after the birth of a child, you should adhere to the following rules:
- Eating right during pregnancy will help avoid gastrointestinal disorders;
- can't stand it strong desire urination;
- wear special devices to support the abdomen, because the fetus can injure the bladder;
- Carrying out daily exercises will help keep your muscles toned.
Also, pregnant women should not forget about good rest and maintaining a daily routine. This will help you not to overexert yourself.
- a condition characterized by uncontrolled urination. Normally, urine output is controlled by immobility, the anatomical and functional integrity of the organs of the urinary system, and the normal innervation of the urethral sphincter muscles. As the size of the uterus increases during pregnancy, the tension of the ligaments increases, and the pelvic floor muscles bear greater loads. There are also changes in the relative position of neighboring organs (uterus, rectum, vagina, bladder, urethra), which entails postpartum changes in the functioning of the body.
This condition occurs in 10-15% of cases in women who have given birth for the first time, with repeated births the value increases to 40%.
Classification
There are many reasons for the occurrence of pathology, ranging from emotional disturbances to changes in the functioning of internal organs. There are the following eight types of involuntary urination:- Stress urinary incontinence - occurs in women after shocks received during childbirth, manifests itself as uncontrolled urination with a sharp jump in intraperitoneal pressure: coughing, sneezing, laughing.
- Reflex - occurs as a result of a reaction to provoking situations, such as the sound of water, a loud cry.
- Imperative (urgent) - occurs with a strong sudden urge to urinate, regardless of the fullness of the bladder.
- Involuntary leakage - when drip urination occurs throughout the day.
- Urinary incontinence after urination - after emptying the bladder, urine flow continues for 1-2 minutes.
- Nocturnal enuresis - at night the sphincter relaxes, which leads to urination.
- Horizontal - urine incontinence when resting in supine position or during an intimate process.
- Overflow incontinence occurs acute delay urine, discharge occurs in small quantities, despite the overcrowding of the bladder.
Causes of urinary incontinence
Regulation of the bladder requires precise interaction and feedback between the organs of the urinary system, the pelvic muscles, as well as the brain and spinal cord. The function of holding urine is performed by two structures: the first is the sphincter, which clamps the urethra in the place where it exits the bladder and prevents urine from flowing out, the second is a muscle band that holds the muscles and all pelvic organs, and is also another sphincter , which can be arbitrarily strained, pinching the urethra and preventing urine from pouring out.Performs urinary function whole line coordinated actions, the violation of which may be due to one of the following seven reasons:
- Difficult long labor - when the muscles of the perineum or pelvic floor are torn, or delivery operations are necessary (application of obstetric forceps, vacuum extraction of the fetus).
- Genetic factor - the presence of relatives suffering from this disease.
- Hormonal disorders - a drop in the amount of estrogen after pregnancy impairs the functioning of the vaginal self-cleaning system, which leads to the development infectious diseases urinary tract.
- Neurological diseases - disruption of muscle innervation due to postpartum spinal injuries.
- The presence of diseases of the urinary system, such as cystocele, urethrocele, chronic cystitis.
- Mechanical damage due to rough and improper actions of an obstetrician-gynecologist.
- Obesity causes atrophy of the pelvic muscles.
Symptoms of urinary incontinence
Postpartum urinary incontinence can occur in a number of cases: during physical activity, sexual intercourse, laughing, sneezing. There is a feeling of incomplete emptying of the bladder, itching and burning of the genitals, constant desire relieve yourself. The amount of urine produced during the day can vary from a few drops to a continuous leak.
Diagnosis of the disease
If symptoms of urinary incontinence appear, you should consult a urologist. He will collect anamnesis, conduct an initial examination, and refer you for laboratory tests and hardware diagnostics. After which the patient will be prescribed an individual course of treatment.First, the abdominal cavity, genitourinary organs, and pelvic area are examined, and a rectal examination is performed. When examining the abdominal cavity, the doctor presses on the abdomen, thus checking whether the bladder is enlarged or whether there are tumor formations.
The pelvic organs are examined on a gynecological chair. The doctor inserts a speculum into the vagina, with which he examines inner surface for the presence of postpartum injuries. In this way, signs of estrogen deficiency and a decrease in the thickness of the vaginal walls can be detected.
The doctor inserts two fingers into the vagina and checks the organs for pain response, the presence of abnormal formations, prolapses or prolapses, and examines the tone of the pelvic muscles. He may ask the patient to contract the muscles and stand up or down so that the bladder and uterus also move forward. In a tense state, bladder weakness can be detected, which cannot be installed when lying down.
During a digital rectal examination in women, the doctor inserts one gloved finger into the rectum and another into the vagina. By examining both organs at the same time, it is possible to detect obstruction of the urethra, as well as re-examine the condition of the uterus and ovaries from a different angle.
After the examination, a general and biochemical analysis blood, urine. When the results are received, the doctor will draw up a treatment plan; if the picture of the disease is not completely clear, then you will need to undergo a series of urodynamic studies.
- a procedure during which a cystoscope is inserted into the bladder through the urethra. It becomes possible to study the mucous membrane of the urinary system for the presence of inflammation.
Cystometry - diagnostic test, during which the pressure in the bladder is measured as it fills. Using a catheter, the bladder is gradually filled with sterile water, the doctor observes and measures the strength and speed of reflex reactions, another catheter is inserted into the rectum or vagina, which allows intra-abdominal pressure to be measured. The urologist asks the patient when he feels the bladder is full and when the urge to urinate appears and draws conclusions.
Uroflowmetry allows you to measure the force and speed of urination, as well as the amount of urine released. The woman sits on a special toilet seat, the doctor records the time spent urinating, its force and the amount of urine released in one second. These data make it possible to determine whether the bladder contracts normally and the patency of the urethra.
Treatment of urinary incontinence
IN initial stage diseases use special conservative treatment methods. Apply medications, such as vaginal suppositories, antidepressants - Tofranil or Duloxetine, as well as Omnic, Cymbalta, Spazmex tablets. Experts advise performing Kegel exercises to strengthen the pelvic muscles, physiotherapeutic procedures (electrophoresis).If these methods are ineffective, surgical intervention will be required. Today, there are about 150 types of surgical operations to eliminate this disease.
Most often used universal method when a synthetic tape 8 cm long and 4 mm wide is inserted under the urethra. The operation takes place under local anesthesia for 15 minutes, after which the patient is under the supervision of specialists for 2-3 hours. The effectiveness of this procedure is 95%, which eliminates the possibility of relapse.
A new method in urology, when the doctor inserts a special chemical composition, who came to gynecology from plastic surgery– polyacrylamide gel. It provides seals to the organ, closing the diameter of the urethra, which helps maintain the tone of the urethra. The duration of the operation is 5 minutes, and the effectiveness is 70%.
Prevention
This problem brings discomfort to daily life women. It is important to maintain an active lifestyle that includes everything sporting events(morning exercises, running, gymnastics, swimming, yoga), monitor body weight, avoid overuse sugar, coffee, alcoholic drinks. Support water balance body, promptly treat inflammatory diseases.It is necessary to carry out special exercises to improve the pelvic muscles. The Kegel exercise involves alternately tensing and relaxing the vaginal muscle fibers; it is recommended to do 5 sets of 50 times a day. To feel which muscles need to be contracted, a woman needs to use them to interrupt the act of urination.
Several weeks passed after the birth, the perineal incision had already healed, the lochia had stopped, and the baby smiled for the first time. However, joy is not always cloudless. If a baby needs diapers, that's normal. It will take a long time before he learns to control his bladder and empty his stomach. But it happens that a young mother suddenly has similar problems: after giving birth her bladder has lost the ability to close tightly, so when laughing or sneezing, a few drops of urine are always released.
Atony bladder after childbirth- a very common disease. A large number of women face this problem, but many, embarrassed to talk about it, keep silent about it.
This is a serious mistake. It is possible to cope with urinary incontinence acquired as a result of childbirth. It is to blame for the weakness of the muscles of the pelvic floor, and the muscles are easy to train.
To do this you need to know how it works female body. Internal organs The upper part of the body is supported by the diaphragm, and organs of the hypogastric region such as the urethra (urethra), intestines, and uterus are supported by the pelvic floor. The muscle layer that forms the floor of the pelvis is stretched, like a hammock, between pubic bone and coccyx, and has only three openings: for the urethra, vagina and anus. Usually the muscles of the pelvic floor are in a state of moderate tension. They push the bladder and urethra upward; the last one, being in vertical position, tightly locks the bladder.
The bladder has two opposing tasks: to collect urine (then the urethra must close it tightly) and to empty itself (the urethra in this case relaxes and allows urine to pass through). Both happen by themselves: the bladder and urethra consist of smooth muscles that are not subject to volitional influence.
The pelvic floor, on the other hand, consists of striated muscles that can be trained and voluntarily controlled. This is important for labor, when a woman in the expulsion phase relaxes her pelvis, tenses her muscles, or strains. The longer labor lasts and the bigger baby, the more the muscles of the pelvic floor are stretched (and often overstretched). As a result, the muscles of the pelvic floor lose their elasticity, become weakened or even sag, and therefore the angle formed by the urethra and bladder. The normal functioning of the locking mechanism is disrupted. If, in addition, the pressure in the abdominal cavity increases - due to coughing, sneezing, laughing, climbing stairs or lifting heavy objects - then a few drops of urine end up in the panties.
After a normal delivery, almost every woman has a weakened pelvic floor. Therefore, it is necessary to strengthen its muscles at the first symptoms of incontinence, and best of all, before they appear.
The best workout is exercises that you can start doing after about two to three weeks. The essence of these exercises, repeated ten times a day, ten times, is to consciously tense and relax the pelvic floor again. To understand how this is done, try while on the toilet several times a short time interrupt urination or tighten the anal sphincter. If you are not sure that when performing the exercise, the muscles that are really needed are compressed, and not just the buttocks, then to check it is best to insert two fingers about two centimeters into the vagina. If at the moment of compression you feel that your fingers are becoming tighter, then you are doing everything correctly.
The advantage of these squeezing exercises is that they can be done anywhere and unnoticed by others - while washing dishes and behind the scenes. desk, in the bus.
There are special pessaries (not to be confused with birth control pills) that are placed in the vagina, push the urethra upward and hold the bladder in the desired position. As the closure angle becomes correct again, involuntary urine flow stops.
Medicines that are prescribed for older women after menopause for bladder atony do not help young mothers, since their incontinence is not caused by estrogen deficiency.
It is better to start squeezing exercises and gymnastics consistently and regularly before the start of pregnancy. Studies conducted on female athletes have shown that the trained pelvic floor muscles lose only 20% of weight (and thus strength) as a result of pregnancy, while the untrained pelvic floor loses 80%. Thus, the risk of negative consequences of pregnancy for the pelvic floor increases.
But those who begin to perform squeezing exercises only after complaints appear also have a good chance of recovery.
Exercises to strengthen the pelvic muscles
IN A POSITION ON YOUR BACK: As you inhale, stick your stomach out, as you exhale, lift your buttocks and pull in your stomach for two to three seconds.
IN THE SIDE POSITION: as you exhale, press your heel to your heel and move one knee to the side, stretch your back, while inhaling, bring your knees together.
BEST WORKOUT - EXERCISES
Gymnastics for the pelvic floor is very effective - special exercises that can be shown to you in classes physical therapy. With consistent training, most women with mild incontinence can heal themselves. You should consult your doctor about other methods of treating urinary incontinence.
It’s not customary to talk about peeing and it’s embarrassing to admit even to your closest friends. And as a rule, you are left alone with this misfortune. It was like that before. Now, for answers to all our questions, we confidently rush into the vastness of the Internet, clicking on the titles of the pages we like. We invite you, without shame or hesitation, to plunge into information about the problem of incontinence after childbirth and find out solutions.
How and when does the problem of urinary incontinence appear after childbirth?
Uncontrolled urination after childbirth is not that uncommon and 30-40% of women experience it. It occurs immediately after childbirth, but not everyone notices it in time in case of minor leakage, confusing it with postpartum discharge. Which, as you know, last on average 6-8 weeks. Next - about what it is like according to eyewitnesses who have encountered such an unpleasant phenomenon in their life as urinary incontinence in women after childbirth.
Absence of a signal from the bladder - when you don’t feel like it’s time to go to the toilet, until a feeling of fullness and aching appears in your stomach. To stimulate the urination process, many people visit the ladies' room every two hours, turning on the tap water. And to the sound of rushing water, with varying degrees of success, it is possible to expel some portion of urine from oneself without any particular urge.
Otherwise, the urine-filled bladder empties itself, but as usual, in the most inappropriate place for this. Or the signal that it’s time to have a bowel movement comes treacherously late and, again, often in an inappropriate environment. Or a meaningfully murmuring thought accidentally flashed through my brain. And you simply don’t have time to get to a place suitable for peeing purposes.
And the embarrassment that a woman experiences after such a AWOL belonging to her by right, but living own life bladder, defies any description. Urinary incontinence is a real punishment for a woman and leads her to a real phobia - the fear of leaving her home with such a close bathroom, and involuntarily makes her a home recluse after childbirth.
There is a more relieved, but no less annoying, urinary incontinence after childbirth. When sneezing, coughing, laughing and the slightest tension in the abdominal muscles, a small amount of urine is released. Daily sanitary pads usually cope with hiding this misunderstanding in secret.