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Many women experience mild female
stress incontinence during the last
trimester of pregnancy. This mild
incontinence usually resolves itself
once the baby is born and there is no
longer extra pressure on the bladder.
And the third factor is childbirth
itself. As during childbirth, enormous
stress is placed on the bladder, its
supporting muscles and ligaments,
which actually causes them to become
lax. Nerves that innervate the bladder
can also be damaged. Factors that
predispose to the development of
incontinence include birthing a large
baby, the use of instruments such as
forceps, prolonged labour, multiple
births, and episiotomies. Incontinence
that results from childbirth may be
evident immediately after giving birth
or may take years to manifest itself.
Occasionally, childbirth may cause
organs such as the bladder or uterus
to prolapsed, or relax, downwards.
Treatment
To diagnose the problem, your
doctor will first ask about symptoms
and medical history. Your pattern
of voiding and urine leakage may
suggest the type of incontinence.
Other obvious factors that can help
define the problem include straining
and discomfort, use of drugs, recent
surgery, and illness. If your medical
history does not define the problem,
it will at least suggest which tests are
needed.
However pregnancy incontinence
doesn’t have to make your life
miserable when you’re pregnant. One
proactive step to take is to schedule
your bathroom breaks. When you
are pregnant, you will have to urinate
much more frequently than before.
Being more cognizant of that will
help you avoid leakage; aim to urinate
every 30 minutes — before you have
the urge — and then try to extend the
time between this each day. This may
mean scheduling bathroom breaks
into your day so you don’t get caught
with a bladder that’s too full when you
can’t get to a restroom.
Also Kegel exercises help to
strengthen the pelvic floor and help
you avoid leakage, but you need to
practice in order to do them properly.
The exercise starts by stopping the
flow of urine the next time you
urinate. Simply contract the same
muscles you would to stop the flow
of urine, hold the contraction for a
count of 10, and then release. The
American Congress of Obstetricians
and Gynecologists suggests doing
Kegel exercises 10 to 20 times in a
row two or three times a day. In a
review of studies, researchers found
that women who practiced pelvic
floor muscle training when they
were pregnant with their first baby
prevented leakage later in pregnancy
and after giving birth. Kegel exercises
also helped women who had
persistent incontinence problems
after giving birth. Keep in mind that
it takes about four to eight weeks of
doing them regularly before you’ll
see results.
Also watch the weight gain as studies
show that women who weigh more
when they get pregnant or who
gain an excessive amount of weight
during pregnancy are more likely
to experience urinary incontinence.
Basically those extra kilos put extra
pressure on your bladder during
pregnancy.
Medications
Medications can reduce many types of
leakage. Some drugs inhibit contractions
of an overactive bladder. Others relax
muscles, leading to more complete
bladder emptying during urination.
Some drugs tighten muscles at the
bladder neck and urethra, preventing
leakage. And some, especially hormones
such as estrogen , are believed to
cause muscles involved in urination
to function normally. Some of these
medications can produce harmful side
effects if used for long periods. Talk to
your doctor about the risks and benefits
of long-term use of medications.
Surgery
Doctors usually suggest surgery to
alleviate incontinence only after other
treatments have been tried. Many
surgical options have high rates of
success. For severe cases of stress
incontinence, the surgeon may secure
the bladder with a wide sling. This
not only holds up the bladder but also
compresses the bottom of the bladder
and the top of the urethra, further
preventing leakage.
Other Tips To Avoid
Pregnancy Incontinence:
• Try to avoid constipation during
pregnancy, so that your full bowels
don’t put added pressure on your
bladder.
• Keep drinking at least eight
glasses of fluids every day as
cutting back on fluids can make
you susceptible to dehydration and
urinary tract infection.
• Avoid coffee, citrus, tomatoes,
and soft drinks which can irritate
your bladder and make it harder to
control those leaks.
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Apr/May 2014