HCA Midwest Health - December 21, 2016

You probably knew that pregnancy would change your body. But like many women, you're a bit surprised by the changes that began, and quite possibly continued, after your baby was born. You're not alone. No matter how healthy and prepared you are during your pregnancy, you're never quite prepared for the many ways your body changes.

The bladder problem you're describing is pretty common, in fact one in four women suffer with it. It's called stress incontinence-urine leaks out whenever your bladder is stressed (a cough, sneeze or really good laugh will do it almost every time). This can happen after childbirth whether you delivered naturally, assisted or had a C-section. That's because the muscles around the bladder weaken with the added weight of pregnancy or rigor of childbirth.

Other bladder problems are also more common after childbirth. Urgency incontinence (also called overactive bladder) is when the need to urinate comes on suddenly, leading to the sensation of "gotta go, gotta go" followed by a dash to the nearest restroom.

Both these types of incontinence can also be caused by weight gain outside of pregnancy or simply aging. Because they're so common (and a bit embarrassing) a lot of women make the mistake of thinking stress incontinence is just a normal part of getting older and can't be helped.

But urinary incontinence does not have to become a permanent part of any woman's life. Treatment may be as simple as regular Kegel exercises to strengthen the pelvic floor muscles that support bladder control. But there are several other effective treatments available and talking to a doctor will help you determine which one(s) are best for you.

We asked one of our own, Dr. Megan Sneed, OB/GYN, to provide some suggestions. Dr. Sneed specializes in minimally invasive gynecologic procedures, pelvic floor reconstruction and female urology. She's currently the only female board-certified urogynecologist in the HCA Midwest Health system and one of very few board-certified urogynecologist in the Kansas City area. You may have even seen her recently appearing on KCTV news segments delivering a variety of important information on women's health.

"The important thing is to seek treatment," said Dr. Sneed. "This is not something you just have to 'get used to' - it's a medical problem and there are medical solutions. The treatment will depend on the type of urinary incontinence, but it can be treated."

Treatments may include a combination of bladder retraining, pelvic-floor therapy, biofeedback and medications.

Dr. Sneed recommends starting with simple techniques that can be done at home, such as

  • Timed voiding. Use a diary to record urination times as well as times when you experience urine leakage. Once you find the patterns in your leaks, you can predict future events and go to the bathroom before a leak happens.
  • Bladder training. This involves going to the bathroom at regular intervals, then very slowly increasing the amount of time between those intervals, training your bladder to wait for longer periods of time before releasing urine. This will strengthen the muscles that control urination and give you more control of them over time.
  • Kegel exercises. Find your pelvic floor muscles by stopping urination in midstream. Once you know what they are, you can do Kegel exercises anywhere (but don't keep doing them when urinating or you risk a urinary tract infection). Just tighten your pelvic muscles and hold the contraction for 5 seconds, then release for 5 seconds and repeat several times. Work up to 10 seconds each, then longer. Remember to breathe and try to not tighten any muscles in your abdomen or buttocks, only your pelvic floor muscles. Eventually, you'll want to work up to doing 10 Kegels at least 3 times a day.

These techniques will help most women, but further treatment may also be needed. There are medications that relax an overactive bladder or strengthen urethra muscles to help keep urine in place.

For women who have a significant stress incontinence, the biggest improvement often comes from surgery.

"Most women can get almost a near cure from a simple 15-minute outpatient procedure that is very low risk with a very high success rate," said Dr. Sneed. "All bladder control issues can be treated, and no woman should have to suffer."

To find a urogynecologist in Kansas City and make an appointment:

Call (877) 769-6636

tags: t4b , womens health