Incontinence

Incontinence during Pregnancy – causes and treatment

During pregnancy, many women experience at least some degree of urinary incontinence (involuntary loss of urine). Incontinence can be mild and infrequent for pregnant women, but it can be more serious for others. Incontinence can continue after pregnancy and may not be present immediately after birth.

Causes:
Urinary incontinence during pregnancy can also result from an overactive bladder. Women with overactive bladder need to urinate more than usual because your bladder has uncontrollable spasms. Also, the muscles around the urethra – the tube through which urine passes from the bladder – may be affected. These muscles are designed to prevent urine that leaves the body.

The sphincter of the bladder controls the flow of urine and it is a muscular valve that is located at the bottom of the bladder. When a woman is pregnant, the uterus that is expanding puts extra pressure on bladder which can cause the sphincter muscles are overwhelmed by this stress and as a result the urine may leak from the bladder.

After pregnancy, incontinence problems may continue because childbirth weakens pelvic floor muscles, which can cause an overactive bladder. Pregnancy and childbirth can contribute to problems with bladder control due to the following conditions:

- Damage to the nerves that control bladder.
- The fact that the urethra and bladder have moved during pregnancy.
- The episiotomy, a cut in the muscle of the pelvic floor during delivery of a baby to allow the fetus to flow easily.

Treatment:
Most women with urinary incontinence can be effectively managed in general practice with fairly simple treatment.
Surgical treatment
Colposuspension: The support of the bladder muscles can also be improved by Colposuspension, in which the top of the vagina is pulled forward and stitched. This is usually successful and does not causes any problems with sex.
1.Procedure of surgical tape. A result similar to Colposuspension can now be achieved by using surgical tape that is able to support the bladder. This procedure takes 30 minutes to complete and can be performed as a day procedure cases, under a local or general anesthesia. Early results show a success rate that is comparable with Colposuspension.
2.Laparoscopic (minimally invasive) surgery is also showing promise as a new technique in the treatment of incontinence.

Non surgical treatment
- Bladder training aims to teach the bladder does not send signals to the brain prematurely. A training program is designed to gradually increase the length of time a person must wait before emptying the bladder, so the reasonable control of a full bladder can be achieved. This is recommended for a minimum of six weeks.
- Hormone replacement therapy is useful to help urge incontinence in women after menopause. It is particularly effective in stress incontinence.

Kegel exercises
They are another method that can be used to help control urinary incontinence. These exercises help to reinforce and strengthen pelvic floor muscles. Strengthening the pelvic floor muscles can improve the function of the urethra and rectal sphincter. One way to help locate the Kegel muscles is to insert a finger into the vagina and try to make the muscles around your finger tightened.
To perform Kegel exercises, you should:
• Keep your abdomen, hips and buttocks relaxed
• Tighten the pelvic floor muscles, keep your muscles for a count of 10
• relax the pelvic floor muscles for a count of 10

If the problem continues to persist consult your doctor for that.

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